Provider Demographics
NPI:1982735049
Name:GERALD HILL, M.D., P.A.
Entity Type:Organization
Organization Name:GERALD HILL, M.D., P.A.
Other - Org Name:IMPAIRMENT EVALUATION CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-791-1272
Mailing Address - Street 1:3802 21ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1011
Mailing Address - Country:US
Mailing Address - Phone:806-791-1272
Mailing Address - Fax:806-791-1955
Practice Address - Street 1:3802 21ST ST STE A
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1011
Practice Address - Country:US
Practice Address - Phone:806-791-1272
Practice Address - Fax:806-791-1955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3263261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC16912Medicare UPIN