Provider Demographics
NPI:1720686496
Name:HILL COUNTRY HEALTH PLLC
Entity Type:Organization
Organization Name:HILL COUNTRY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HATIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-868-1522
Mailing Address - Street 1:1010 RR 620 S STE 107
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5638
Mailing Address - Country:US
Mailing Address - Phone:217-721-0961
Mailing Address - Fax:
Practice Address - Street 1:1010 RANCH ROAD 620 S STE 107
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5638
Practice Address - Country:US
Practice Address - Phone:217-721-0961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty