MEDICARE: DR. HERMANN F. HINZE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	22581	TX

General Provider Information

NPI Number	:	1841253689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERMANN F. HINZE DMD

Provider Business Mailing Address
First Line	:	711 W 38TH ST STE G5
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1134
Country	:	US
Telephone Number	:	512-453-1600
Fax Number	:	512-453-1503

Provider Business Practice Location Address
First Line	:	711 W 38TH ST STE G5
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1134
Country	:	US
Telephone Number	:	512-453-1600
Fax Number	:	512-453-1503

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	07/20/2012

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