Provider Demographics
NPI:1225084742
Name:HILL, ELIZABETH L (DO)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:HILL
Suffix:
Gender:F
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:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76095-0727
Mailing Address - Country:US
Mailing Address - Phone:817-354-7070
Mailing Address - Fax:817-354-7073
Practice Address - Street 1:601 W PARK WAY
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3972
Practice Address - Country:US
Practice Address - Phone:817-354-7070
Practice Address - Fax:817-354-7073
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00160992OtherMEDICARE RR, IND.
TX8K6460OtherBCBS IND.
TX045787103Medicaid
TXK5997OtherSTATE LICENSE
G72837Medicare UPIN
TX8B4178Medicare PIN