| Randy Hines Md Pa | |
|
3501 S Soncy Rd Ste 1002 Amarillo TX 79119-4932 | |
| (806) 677-0500 | |
| (806) 677-0860 |
| Full Name | Randy Hines Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 3501 S Soncy Rd Ste 1002, Amarillo, Texas |
| Authorized Official Name and Position | Thomas Randall Hines (OWNER) |
| Authorized Official Contact | 8066770500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randy Hines Md Pa 3501 S Soncy Rd Ste 1002 Amarillo TX 79119-4932 Ph: (806) 677-0500 | Randy Hines Md Pa 3501 S Soncy Rd Ste 1002 Amarillo TX 79119-4932 Ph: (806) 677-0500 |
| NPI Number | 1326166497 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 06/03/2009 |
| Medicare PECOS PAC ID | 7214910983 |
|---|---|
| Medicare Enrollment ID | O20040611001382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326166497 | NPI | - | NPPES |
| 00554W | Other | TX | MEDICARE PTAN |
| 164624201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K6469 (Texas) | Primary |
| Provider Name | Thomas R Hines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336141670 PECOS PAC ID: 0840273512 Enrollment ID: I20040612000526 |
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