Provider Demographics
NPI:1922763465
Name:HILL, RICHARD (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12800 BRIAR FOREST DR UNIT 20
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2211
Mailing Address - Country:US
Mailing Address - Phone:832-531-9982
Mailing Address - Fax:
Practice Address - Street 1:4501 W EXPY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-0029
Practice Address - Country:US
Practice Address - Phone:956-627-0741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-31
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1220363AM0700X
PR1202363AM0700X
246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical