Provider Demographics
NPI:1881211290
Name:HILL COUNTRY BIRTH CENTER
Entity Type:Organization
Organization Name:HILL COUNTRY BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:LM CPM
Authorized Official - Phone:512-686-6262
Mailing Address - Street 1:1407 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-1012
Mailing Address - Country:US
Mailing Address - Phone:512-686-6262
Mailing Address - Fax:512-817-4741
Practice Address - Street 1:1407 N WATER ST
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-1012
Practice Address - Country:US
Practice Address - Phone:512-686-6262
Practice Address - Fax:512-817-4741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX409990501Medicaid