Healthcare Provider Details

I. General information

NPI: 1245260611
Provider Name (Legal Business Name): VANESSA L. HILL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N SANTA ROSA ST
SAN ANTONIO TX
78207-3108
US

IV. Provider business mailing address

315 N SAN SABA STE 1003
SAN ANTONIO TX
78207-3100
US

V. Phone/Fax

Practice location:
  • Phone: 210-704-3718
  • Fax: 210-704-4520
Mailing address:
  • Phone: 210-704-3718
  • Fax: 210-704-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberM4156
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM4156
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM4156
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: