Provider Demographics
NPI:1992834261
Name:BRUNNER, HILLARY ELIZABETH (DPM)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:ELIZABETH
Last Name:BRUNNER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 OASIS
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-8574
Mailing Address - Country:US
Mailing Address - Phone:917-575-5488
Mailing Address - Fax:
Practice Address - Street 1:2903 BILLY HEXT ROAD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765
Practice Address - Country:US
Practice Address - Phone:432-550-3668
Practice Address - Fax:432-550-3671
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1926213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
285222 YRU6Medicare PIN
NYWP2231Medicare PIN