Provider Demographics
NPI:1538290085
Name:TROY DILLON
Entity Type:Organization
Organization Name:TROY DILLON
Other - Org Name:KATHY DILLON
Other - Org Type:Other Name
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CSA,
Authorized Official - Phone:830-379-2902
Mailing Address - Street 1:5077 WINDMILL PR
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-0276
Mailing Address - Country:US
Mailing Address - Phone:830-379-2902
Mailing Address - Fax:830-379-2902
Practice Address - Street 1:CENTRAL TEXAS MEDICAL CENTER
Practice Address - Street 2:1301 WONDER WORLD DRIVE
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666
Practice Address - Country:US
Practice Address - Phone:512-753-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX736495163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty