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Individual

DR. DWIGHT A HINES II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
203 S 3RD ST, GRANDVIEW, TX 76050-2165
(817) 866-2100
Mailing address
203 S 3RD ST, GRANDVIEW, TX 76050-2165
(817) 866-2100
(817) 866-2169

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
J5587
TX
207Q00000X
Family Medicine Physician
Primary
J5587
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115972504
TX
Enumeration date
04/18/2006
Last updated
03/02/2011
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