Provider Demographics
NPI:1952326993
Name:HILL COUNTRY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:HILL COUNTRY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDSMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-221-3210
Mailing Address - Street 1:774 LANDA ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6114
Mailing Address - Country:US
Mailing Address - Phone:830-625-0305
Mailing Address - Fax:830-625-2693
Practice Address - Street 1:774 LANDA ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6114
Practice Address - Country:US
Practice Address - Phone:830-625-0305
Practice Address - Fax:830-625-2693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00R38TOtherBLUE CROSS BLUE SHIELD
TX00R38TOtherBLUE CROSS BLUE SHIELD