Provider Demographics
NPI:1760483291
Name:HILTON, DONALD LONG JR (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:LONG
Last Name:HILTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 MEDICAL DR
Mailing Address - Street 2:STE 610
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6306
Mailing Address - Country:US
Mailing Address - Phone:210-614-2453
Mailing Address - Fax:210-614-4457
Practice Address - Street 1:4410 MEDICAL DR
Practice Address - Street 2:STE 610
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6306
Practice Address - Country:US
Practice Address - Phone:210-614-2453
Practice Address - Fax:210-614-4457
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH7313207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038587401Medicaid
TX038587401Medicaid
00K501Medicare ID - Type Unspecified