Provider Demographics
NPI:1457321077
Name:HILL, THOMAS A (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 E 32ND ST
Mailing Address - Street 2:406
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2701
Mailing Address - Country:US
Mailing Address - Phone:512-495-1850
Mailing Address - Fax:512-495-1883
Practice Address - Street 1:1015 E 32ND ST
Practice Address - Street 2:406
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2701
Practice Address - Country:US
Practice Address - Phone:512-495-1850
Practice Address - Fax:512-495-1883
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9496174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146577501Medicaid
TXC16904Medicare UPIN
TX8132N0Medicare PIN