MEDICARE: KERRY L. HINCKS DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	125-047892	IL
2	207Q00000X	Family Medicine Physician	Q7205	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	809840	OTHER	IL	MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	CA4079	OTHER	IL	RR GROUP #
3	P00433545	OTHER	IL	RR INDIVIDUAL #

General Provider Information

NPI Number	:	1104847458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRY L. HINCKS DO

Provider Business Mailing Address
First Line	:	8810 HIGHWAY 6 STE 100
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7104
Country	:	US
Telephone Number	:	713-486-1200
Fax Number	:	281-778-5345

Provider Business Practice Location Address
First Line	:	8810 HIGHWAY 6 STE 100
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7104
Country	:	US
Telephone Number	:	713-486-1200
Fax Number	:	281-778-5345

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	03/09/2022

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Directions to “ KERRY L. HINCKS DO” Practice Location

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