Provider Demographics
NPI:1730411042
Name:HILL COUNTRY PHYSICIAN ASSOCIATES
Entity type:Organization
Organization Name:HILL COUNTRY PHYSICIAN ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:NAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-997-1096
Mailing Address - Street 1:820 REUBEN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4436
Mailing Address - Country:US
Mailing Address - Phone:830-997-1096
Mailing Address - Fax:830-997-1901
Practice Address - Street 1:820 REUBEN ST
Practice Address - Street 2:SUITE B
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4436
Practice Address - Country:US
Practice Address - Phone:830-997-1096
Practice Address - Fax:830-997-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty