1932303864 NPI number — HILL COUNTRY GENERAL AND ONCOLOGY SURGERY ASSOCIATES P A

Table of content: (NPI 1932303864)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932303864 NPI number — HILL COUNTRY GENERAL AND ONCOLOGY SURGERY ASSOCIATES P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HILL COUNTRY GENERAL AND ONCOLOGY SURGERY ASSOCIATES P A
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:
1932303864
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2409
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICKSBURG
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78624-1906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-997-8833
Provider Business Mailing Address Fax Number:
830-990-8725

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1009 S MILAM ST
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
FREDERICKSBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78624-4578
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-997-8833
Provider Business Practice Location Address Fax Number:
830-990-8725
Provider Enumeration Date:
06/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STAUFFER
Authorized Official First Name:
JAY
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
830-997-8833

Provider Taxonomy Codes

  • Taxonomy code: 2086X0206X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 122172305 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com