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Organization
FAMILY CHECKUP
Active
Organization
FAMILY CHECKUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEONORILDA HINES FNP (FNP)
(956) 399-1641
Entity
Organization
Contact information
Practice address
400 W US HIGHWAY 77, SAN BENITO, TX 78586-5148
(956) 399-1641
(956) 399-0312
Mailing address
400 W US HIGHWAY 77, SAN BENITO, TX 78586-5148
(956) 399-1641
(956) 399-0312
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
641882
TX
363LF0000X
Family Nurse Practitioner
Primary
641882
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
641882
LICENSE NUMBER
TX
01
—
TXB140393
MEDICARE GROUP PTAN
TX
Enumeration date
10/21/2011
Last updated
12/16/2011
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