Provider Demographics
NPI:1164905568
Name:HILL, TRUMAN GORDON II (PTA)
Entity Type:Individual
Prefix:
First Name:TRUMAN
Middle Name:GORDON
Last Name:HILL
Suffix:II
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79045-4664
Mailing Address - Country:US
Mailing Address - Phone:806-206-0731
Mailing Address - Fax:
Practice Address - Street 1:1009 CLYDE ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4225
Practice Address - Country:US
Practice Address - Phone:806-352-5295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2080050225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant