Provider Demographics
NPI:1104219732
Name:DR. JERRON C HILL
Entity Type:Organization
Organization Name:DR. JERRON C HILL
Other - Org Name:TEXAS STAR ANESTHESIA OBSTETRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRON
Authorized Official - Middle Name:CARLYLE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-437-4801
Mailing Address - Street 1:PO BOX 702097
Mailing Address - Street 2:SUITE 485
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75370-2097
Mailing Address - Country:US
Mailing Address - Phone:972-980-0500
Mailing Address - Fax:972-980-0503
Practice Address - Street 1:4101 MCEWEN RD
Practice Address - Street 2:SUITE 485
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-5112
Practice Address - Country:US
Practice Address - Phone:972-980-0500
Practice Address - Fax:972-980-0503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4969207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty