Healthcare Provider Details

I. General information

NPI: 1336520717
Provider Name (Legal Business Name): ANDREW JERRY HINOJOSA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 07/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5846 WOOLDRIDGE RD
CORPUS CHRISTI TX
78414-2402
US

IV. Provider business mailing address

5846 WOOLDRIDGE RD
CORPUS CHRISTI TX
78414-2402
US

V. Phone/Fax

Practice location:
  • Phone: 361-994-8979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2015017145
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberR6413
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: