Provider Demographics
NPI:1811023914
Name:HILL COUNTRY EAR, NOSE & THROAT, PA
Entity Type:Organization
Organization Name:HILL COUNTRY EAR, NOSE & THROAT, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:LANO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:830-629-5830
Mailing Address - Street 1:42 GRUENE PARK DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2460
Mailing Address - Country:US
Mailing Address - Phone:830-629-5830
Mailing Address - Fax:830-629-3647
Practice Address - Street 1:42 GRUENE PARK DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2460
Practice Address - Country:US
Practice Address - Phone:830-629-5830
Practice Address - Fax:830-629-3647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9902207Y00000X
TX51495231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0057DJOtherBLUE CROSS BLUE SHIELD
TX081439403Medicaid
TX081439401Medicaid
TX081439402Medicaid
TX0057DJOtherBLUE CROSS BLUE SHIELD
TX00962KMedicare ID - Type Unspecified