Provider Demographics
NPI:1588633846
Name:HOOTKINS, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:HOOTKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 WIMBERLY LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-1493
Mailing Address - Country:US
Mailing Address - Phone:512-797-4668
Mailing Address - Fax:512-330-9591
Practice Address - Street 1:2119 WIMBERLY LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-1493
Practice Address - Country:US
Practice Address - Phone:512-797-4668
Practice Address - Fax:512-330-9591
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0462207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124909601Medicaid
TX124909601Medicaid
TX300093935Medicare PIN
TX86E188Medicare PIN