Provider Demographics
NPI:1861549891
Name:HILLIARD, INGRID (OD)
Entity type:Individual
Prefix:DR
First Name:INGRID
Middle Name:
Last Name:HILLIARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:INGRID
Other - Middle Name:
Other - Last Name:BRILLHART -HILLIARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3240 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4502
Mailing Address - Country:US
Mailing Address - Phone:281-997-2627
Mailing Address - Fax:281-485-8329
Practice Address - Street 1:3240 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4502
Practice Address - Country:US
Practice Address - Phone:281-997-2627
Practice Address - Fax:281-485-8329
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7004985152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00703896OtherRAILROAD MEDICARE
TXU50907Medicare UPIN
TX8F21027Medicare PIN