Provider Demographics
NPI:1477960573
Name:HILL COUNTRY NEUROLOGY P.A.
Entity Type:Organization
Organization Name:HILL COUNTRY NEUROLOGY P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-990-0064
Mailing Address - Street 1:1009 S MILAM ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4578
Mailing Address - Country:US
Mailing Address - Phone:830-990-0064
Mailing Address - Fax:830-990-1173
Practice Address - Street 1:1009 S MILAM ST
Practice Address - Street 2:SUITE 4
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4578
Practice Address - Country:US
Practice Address - Phone:830-990-0064
Practice Address - Fax:830-990-1173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9821174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE83441Medicare UPIN