Provider Demographics
NPI:1699359356
Name:HILL, OLIVIA (CPHT)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8812 PAPA TRL
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2136
Mailing Address - Country:US
Mailing Address - Phone:469-636-0550
Mailing Address - Fax:
Practice Address - Street 1:14450 TRINITY BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76155-2549
Practice Address - Country:US
Practice Address - Phone:817-540-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302372183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302372OtherPHARMACY TECHNICIAN LICENSE