Provider Demographics
NPI:1982016184
Name:HINOJOSA, VIDAL ISAAC (AUD)
Entity Type:Individual
Prefix:DR
First Name:VIDAL
Middle Name:ISAAC
Last Name:HINOJOSA
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 NE LOOP 410
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1625
Mailing Address - Country:US
Mailing Address - Phone:210-826-2319
Mailing Address - Fax:210-826-2921
Practice Address - Street 1:1635 NE LOOP 410
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1625
Practice Address - Country:US
Practice Address - Phone:210-826-2319
Practice Address - Fax:210-826-2921
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80627231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist