Provider Demographics
NPI:1578903688
Name:HINOJOSA, VANESSA MARIE (PAC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:HINOJOSA
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13535 HAUSMAN PASS STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3581
Mailing Address - Country:US
Mailing Address - Phone:210-951-5530
Mailing Address - Fax:210-951-9080
Practice Address - Street 1:13535 HAUSMAN PASS STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3581
Practice Address - Country:US
Practice Address - Phone:210-951-5530
Practice Address - Fax:210-951-9080
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08641363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8938NPOtherBCBS PV#