=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275789679
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSE LUIS HINOJOSA MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2008
-----------------------------------------------------
Last Update Date | 08/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5420 S JACKSON RD
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-6672
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-618-1919
-----------------------------------------------------
Fax | 956-618-4548
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3550
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78540-3550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-618-1919
-----------------------------------------------------
Fax | 956-618-4548
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JOSE LUIS HINOJOSA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 956-618-1919
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------