MEDICARE: HILL COUNTRY PHYSICIAN ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	N3569	TX

General Provider Information

NPI Number	:	1730411042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILL COUNTRY PHYSICIAN ASSOCIATES

Provider Business Mailing Address
First Line	:	820 REUBEN ST
Second Line	:	SUITE B
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-4436
Country	:	US
Telephone Number	:	830-997-1096
Fax Number	:	830-997-1901

Provider Business Practice Location Address
First Line	:	820 REUBEN ST
Second Line	:	SUITE B
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-4436
Country	:	US
Telephone Number	:	830-997-1096
Fax Number	:	830-997-1901

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. MICHELLE ELAINE NAIL
Credential	:
Telephone Number	:	830-997-1096

Provider Enumeration Date	:	02/11/2010
Last Update Date	:	02/11/2010

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