Provider Demographics
NPI:1922120799
Name:HILL, BRIAN W (PHD, MS, PA-C)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:W
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD, MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25807 CHINOOK CORNER
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2857
Mailing Address - Country:US
Mailing Address - Phone:210-281-1794
Mailing Address - Fax:
Practice Address - Street 1:19422 N US HIGHWAY 281
Practice Address - Street 2:SUITE 106
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7614
Practice Address - Country:US
Practice Address - Phone:210-888-9503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002752363A00000X
TXPA06550363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1503030Medicare UPIN
MIMI1503Medicare PIN
MIMI1504Medicare PIN
MIMI1504030Medicare UPIN