Provider Demographics
NPI:1013436112
Name:HINES, ANNA REBECCA (LICENSED MIDWIFE)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:REBECCA
Last Name:HINES
Suffix:
Gender:F
Credentials:LICENSED MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 GASTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1014
Mailing Address - Country:US
Mailing Address - Phone:214-384-9772
Mailing Address - Fax:214-442-5557
Practice Address - Street 1:4720 GASTON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1014
Practice Address - Country:US
Practice Address - Phone:214-384-9772
Practice Address - Fax:214-442-5557
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife