Provider Demographics
NPI:1760406284
Name:JOSE F HILARIO DPM PA
Entity Type:Organization
Organization Name:JOSE F HILARIO DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:F
Authorized Official - Last Name:HILARIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-545-9100
Mailing Address - Street 1:13423 BLANCO RD
Mailing Address - Street 2:#117
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2187
Mailing Address - Country:US
Mailing Address - Phone:210-545-9100
Mailing Address - Fax:210-545-6966
Practice Address - Street 1:14855 BLANCO RD
Practice Address - Street 2:SUITE 212
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7732
Practice Address - Country:US
Practice Address - Phone:210-545-9100
Practice Address - Fax:210-545-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1723213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDG3005OtherMEDICARE RAILROAD
TX175286701Medicaid
TX8F0598Medicare PIN
V04104Medicare UPIN
TX175286701Medicaid
TX5495410001Medicare NSC
TXTXB120244Medicare PIN
TXDG3005OtherMEDICARE RAILROAD