Provider Demographics
NPI:1649496944
Name:JEFF HINES, M.D.,P.A.
Entity type:Organization
Organization Name:JEFF HINES, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-8888
Mailing Address - Street 1:1200 E SAVANNAH AVE
Mailing Address - Street 2:SUITE #8
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1727
Mailing Address - Country:US
Mailing Address - Phone:956-631-8888
Mailing Address - Fax:956-631-1037
Practice Address - Street 1:1200 E SAVANNAH AVE
Practice Address - Street 2:SUITE #8
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1727
Practice Address - Country:US
Practice Address - Phone:956-631-8888
Practice Address - Fax:956-631-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2618207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115010401Medicaid
GA110125155OtherRAILROAD MEDICARE PROVDR#
TXTXB118369Medicare PIN
TX115010401Medicaid