Provider Demographics
NPI:1740436468
Name:GARY ALAN HOPKINS MD, PA
Entity type:Organization
Organization Name:GARY ALAN HOPKINS MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-329-6617
Mailing Address - Street 1:3006 BEE CAVE RD
Mailing Address - Street 2:STE A290
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5588
Mailing Address - Country:US
Mailing Address - Phone:512-329-6617
Mailing Address - Fax:512-329-6772
Practice Address - Street 1:11614 BEE CAVES RD
Practice Address - Street 2:STE 160
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-5405
Practice Address - Country:US
Practice Address - Phone:512-329-6617
Practice Address - Fax:512-329-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7302208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH12044Medicare UPIN