Provider Demographics
NPI:1093705360
Name:CATHCART, CLIFTON HILL JR (DO)
Entity Type:Individual
Prefix:
First Name:CLIFTON
Middle Name:HILL
Last Name:CATHCART
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 E DENMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-6110
Mailing Address - Country:US
Mailing Address - Phone:936-639-1224
Mailing Address - Fax:936-637-7917
Practice Address - Street 1:1702 E DENMAN AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-6110
Practice Address - Country:US
Practice Address - Phone:936-639-1224
Practice Address - Fax:936-637-7917
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0412208VP0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX826086353OtherMEDICARE RAILROAD
TX00CA20OtherBCBS
TX155299401Medicaid
TX751778755OtherTAX ID
TX752934073OtherPAIN AND POSTURE TXID
TX032423803Medicaid
TX8446B0Medicare PIN
TX00CA20OtherBCBS
TX826086353OtherMEDICARE RAILROAD