Basic Information
| Provider Information | |||||||||
| NPI: | 1609245877 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MARK A HINTON, MD PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CHILD AND FAMILY BEHAVIOR OPTIONS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10407 WILLOW BARK | ||||||||
| Address2: | |||||||||
| City: | BOERNE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780068518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2282571978 | ||||||||
| FaxNumber: | 8889599864 | ||||||||
| Practice Location | |||||||||
| Address1: | 8550 HUEBNER RD | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782401803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105415300 | ||||||||
| FaxNumber: | 2105415310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2015 | ||||||||
| LastUpdateDate: | 09/17/2015 | ||||||||
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| AuthorizedOfficialLastName: | HINTON | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/OPERATOR | ||||||||
| AuthorizedOfficialTelephone: | 2282571978 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TP0016X | K1216 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Prescribing (Medical) |
No ID Information.