MEDICARE: SAMANTHA LOREN HINOJOSA MS, RDN, LD

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	133V00000X	Registered Dietitian	DT84857	TX

General Provider Information

NPI Number	:	1790452068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA LOREN HINOJOSA MS, RDN, LD

Provider Business Mailing Address
First Line	:	7215 BLUEMIST PT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-6300
Country	:	US
Telephone Number	:	210-260-5342
Fax Number	:

Provider Business Practice Location Address
First Line	:	1870 W BITTERS RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78248-1826
Country	:	US
Telephone Number	:	210-545-4422
Fax Number	:

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

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	08/25/2021

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