Healthcare Provider Details

I. General information

NPI: 1861895310
Provider Name (Legal Business Name): TERRY HILL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 09/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 UNIVERSITY AVE UNIT 100
LUBBOCK TX
79423-3168
US

IV. Provider business mailing address

8215 UNIVERSITY AVE UNIT 100
LUBBOCK TX
79423-3168
US

V. Phone/Fax

Practice location:
  • Phone: 806-698-1083
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number50381
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: