MEDICARE: CHARLES JEFFERSON HINES M.D.

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	207R00000X	Internal Medicine Physician	E2618	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	RAILROAD MEDICRE	OTHER	GA	RAILROAD MEDICARE NO.

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00HA36	OTHER	TX	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174587471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES JEFFERSON HINES M.D.

Provider Business Mailing Address
First Line	:	1200 E SAVANNAH AVE
Second Line	:	SUITE # 8
City	:	MCALLEN
State	:	TX
Zip	:	78503-1727
Country	:	US
Telephone Number	:	956-631-8888
Fax Number	:	956-631-1037

Provider Business Practice Location Address
First Line	:	1200 E SAVANNAH AVE
Second Line	:	SUITE # 8
City	:	MCALLEN
State	:	TX
Zip	:	78503-1727
Country	:	US
Telephone Number	:	956-631-8888
Fax Number	:	956-631-1037

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	02/18/2016

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Directions to “ CHARLES JEFFERSON HINES M.D.” Practice Location

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