Provider Demographics
NPI:1083849269
Name:HILL COUNTRY RADIOLOGY ASSOCIATES PLLC
Entity Type:Organization
Organization Name:HILL COUNTRY RADIOLOGY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-757-1000
Mailing Address - Street 1:PO BOX 1620
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-8620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1310 PALUXY RD
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5655
Practice Address - Country:US
Practice Address - Phone:817-573-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDP1701OtherRAILROAD MEDICARE
TX204207901Medicaid
TX0084SMOtherBLUE CROSS AND BLUE SHIELD
TX204207901Medicaid