Provider Demographics
NPI:1760213904
Name:HINOJOSA, JOSE ANTONIO JR (PTA)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ANTONIO
Last Name:HINOJOSA
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 MIRANDA LN
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-5103
Mailing Address - Country:US
Mailing Address - Phone:956-223-9095
Mailing Address - Fax:
Practice Address - Street 1:403 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-2112
Practice Address - Country:US
Practice Address - Phone:956-429-3866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2148973225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant