Healthcare Provider Details

I. General information

NPI: 1427042589
Provider Name (Legal Business Name): DONALD J HILLMAN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 08/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W ILLINOIS AVE
MIDLAND TX
79701-6407
US

IV. Provider business mailing address

406 S GARY AVE
MONAHANS TX
79756-4799
US

V. Phone/Fax

Practice location:
  • Phone: 432-685-1111
  • Fax:
Mailing address:
  • Phone: 866-321-8433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA02501
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: