Provider Demographics
NPI:1588855266
Name:HINES, TERRANCE S (MD)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:S
Last Name:HINES
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 1:100 W DEAN KEETON ST
Mailing Address - Street 2:CAMPUS MAIL A3900
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712
Mailing Address - Country:US
Mailing Address - Phone:512-475-8235
Mailing Address - Fax:512-475-9693
Practice Address - Street 1:100 W DEAN KEETON ST
Practice Address - Street 2:CAMPUS MAIL A3900
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712
Practice Address - Country:US
Practice Address - Phone:512-475-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7267207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine