Healthcare Provider Details

I. General information

NPI: 1699747253
Provider Name (Legal Business Name): HORACE GIBSON HINSON III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HEWITT DR
WACO TX
76712
US

IV. Provider business mailing address

PO BOX 5338
WACO TX
76708
US

V. Phone/Fax

Practice location:
  • Phone: 254-202-7800
  • Fax: 254-202-7856
Mailing address:
  • Phone: 254-202-4660
  • Fax: 254-202-4716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH4406
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: