Healthcare Provider Details

I. General information

NPI: 1033404629
Provider Name (Legal Business Name): PETER PHUC HINH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 01/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BINZ ST STE 690
HOUSTON TX
77004-6943
US

IV. Provider business mailing address

10970 SHADOW CREEK PKWY STE 100
PEARLAND TX
77584-0166
US

V. Phone/Fax

Practice location:
  • Phone: 713-366-7831
  • Fax: 713-482-5815
Mailing address:
  • Phone: 713-366-7845
  • Fax: 713-366-7997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberBP10026665
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: