Provider Demographics
NPI:1891984837
Name:HILL COUNTRY MEDICINE
Entity Type:Organization
Organization Name:HILL COUNTRY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:GROVER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:830-249-3800
Mailing Address - Street 1:105 FALLS CT STE 100
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2986
Mailing Address - Country:US
Mailing Address - Phone:830-249-3800
Mailing Address - Fax:
Practice Address - Street 1:105 FALLS CT STE 100
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2986
Practice Address - Country:US
Practice Address - Phone:830-249-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P1230OtherBLUE CROSS BLUE SHIELD
TX00387XMedicare PIN
TXI18008Medicare UPIN