1831353044 NPI number — HILL COUNTRY DIZZINESS & BALANCE CENTER, PLLC

Table of content: (NPI 1831353044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831353044 NPI number — HILL COUNTRY DIZZINESS & BALANCE CENTER, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HILL COUNTRY DIZZINESS & BALANCE CENTER, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831353044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
218 QUINLAN ST
Provider Second Line Business Mailing Address:
SUITE 474
Provider Business Mailing Address City Name:
KERRVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78028-5314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-895-7675
Provider Business Mailing Address Fax Number:
830-896-9340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1331 BANDERA HWY
Provider Second Line Business Practice Location Address:
SUITE 1B
Provider Business Practice Location Address City Name:
KERRVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78028-9515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-792-2132
Provider Business Practice Location Address Fax Number:
830-792-2131
Provider Enumeration Date:
07/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MEHENDALE
Authorized Official First Name:
ANAND
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
830-895-7675

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  F1974 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Y00000X , with the licence number: M6514 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X , with the licence number: G1112 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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