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General NPI Number Information
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NPI Number | 1326166497
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Entity Type | Organization
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Legal Business Name | RANDY HINES MD PA
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 3501 S SONCY RD STE 1002
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City | AMARILLO
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State | TX
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Zip | 79119-4932
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Country | US
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Telephone | 806-677-0500
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Fax | 806-677-0860
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Provider Business Mailing Address
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Address Line | 3501 S SONCY RD STE 1002
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City | AMARILLO
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State | TX
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Zip | 79119-4932
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Country | US
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Telephone | 806-677-0500
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Fax | 806-677-0860
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS RANDALL HINES
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Credential | MD
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Telephone | 806-677-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K6469
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License Number State | TX
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