Healthcare Provider Details
I. General information
NPI: 1407307051
Provider Name (Legal Business Name): HILL COUNTRY CT SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2016
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1900 SCENIC DR SUITE 2220
GEORGETOWN TX
78626-7703
US
IV. Provider business mailing address
12619 FITZHUGH RD. #2
AUSTIN TX
78736
US
V. Phone/Fax
- Phone: 512-715-4227
- Fax: 800-982-7601
- Phone: 512-715-4227
- Fax: 800-982-7601
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | P1849 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
ELI
BECKER
Title or Position: OWNER
Credential: MD
Phone: 512-878-9433