Provider Demographics
NPI:1003621558
Name:HILL, ELAINE (11920597-MT141888)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:11920597-MT141888
Other - Prefix:MRS
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3902 SPRING CIRCLE DR E
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9384
Mailing Address - Country:US
Mailing Address - Phone:832-351-0205
Mailing Address - Fax:
Practice Address - Street 1:3902 SPRING CIRCLE DR E
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9384
Practice Address - Country:US
Practice Address - Phone:832-351-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT141888225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty