Healthcare Provider Details

I. General information

NPI: 1750956835
Provider Name (Legal Business Name): HILL COUNTRY ENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/21/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18568 TEXAS 46 STE 1001
SPRING BRANCH TX
78070
US

IV. Provider business mailing address

18 ENCINOSO
SAN ANTONIO TX
78261-2300
US

V. Phone/Fax

Practice location:
  • Phone: 830-438-9300
  • Fax:
Mailing address:
  • Phone: 210-865-6047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEX J MCKINLAY
Title or Position: OWNER
Credential: MD
Phone: 210-865-6047