Provider Demographics
NPI:1063423416
Name:HINOJOSA, ROLANDO (MD)
Entity type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:
Last Name:HINOJOSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3225
Mailing Address - Country:US
Mailing Address - Phone:956-581-6366
Mailing Address - Fax:956-519-6638
Practice Address - Street 1:2112 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3225
Practice Address - Country:US
Practice Address - Phone:956-581-6366
Practice Address - Fax:956-519-6638
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033624001Medicaid
TX00GL09Medicare ID - Type Unspecified
TXC16962Medicare UPIN