Provider Demographics
NPI:1639151905
Name:HILL COUNTRY CENTER FOR CANCER CARE
Entity Type:Organization
Organization Name:HILL COUNTRY CENTER FOR CANCER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-257-3131
Mailing Address - Street 1:PO BOX 1008
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78667-1008
Mailing Address - Country:US
Mailing Address - Phone:830-990-4800
Mailing Address - Fax:830-257-3161
Practice Address - Street 1:753 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-5239
Practice Address - Country:US
Practice Address - Phone:830-990-4800
Practice Address - Fax:830-257-3161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH30822085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDE5633OtherRR MEDICARE
TX178215301Medicaid
TXDE5633OtherRR MEDICARE