MEDICARE: A 1 FAMILY HEALTH CENTER PA

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

General Provider Information

NPI Number	:	1124105994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A 1 FAMILY HEALTH CENTER PA

Provider Business Mailing Address
First Line	:	PO BOX 690
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77522-0690
Country	:	US
Telephone Number	:	281-427-6363
Fax Number	:	281-420-6867

Provider Business Practice Location Address
First Line	:	2610 N ALEXANDER DR
Second Line	:	SUITE 201
City	:	BAYTOWN
State	:	TX
Zip	:	77520-3368
Country	:	US
Telephone Number	:	281-427-6363
Fax Number	:	281-420-6867

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. DENNIS THOMAS HINES JR.
Credential	:	M.D.
Telephone Number	:	281-427-6363

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	10/30/2007

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