Provider Demographics
NPI:1750371027
Name:HILL COUNTRY EMERGENCY PHYSICIANS PA
Entity type:Organization
Organization Name:HILL COUNTRY EMERGENCY PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:512-753-3796
Mailing Address - Street 1:1301 WONDER WORLD DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7533
Mailing Address - Country:US
Mailing Address - Phone:512-753-3796
Mailing Address - Fax:
Practice Address - Street 1:1301 WONDER WORLD DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7533
Practice Address - Country:US
Practice Address - Phone:512-753-3796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095037001OtherCSHCN
TX095037003Medicaid
TX00013KOtherBCBS
TX00013KOtherBCBS
TX00013KMedicare PIN