Provider Demographics
NPI:1881851889
Name:HINMAN MCILROY, BRENDA DAWN (DO, MPH)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:DAWN
Last Name:HINMAN MCILROY
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 W JOHN HOOVER PKWY
Mailing Address - Street 2:BLDG 3, STE D
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611
Mailing Address - Country:US
Mailing Address - Phone:512-715-3132
Mailing Address - Fax:512-715-3133
Practice Address - Street 1:200 W JOHN HOOVER PKWY
Practice Address - Street 2:BLDG 3, STE D
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611
Practice Address - Country:US
Practice Address - Phone:512-715-3132
Practice Address - Fax:512-715-3133
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORDO158369207V00000X
CA20A12570207V00000X
TXQ1624207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1073652Medicaid
TX340287701Medicaid
TX340287702Medicaid
LA1073652Medicaid
TX340287701Medicaid