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General NPI Number Information
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NPI Number | 1407594062
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Entity Type | Organization
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Legal Business Name | HILL COUNTRY PEDIATRIC PSYCHIATRY PLLC
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 26254 INTERSTATE 10 W STE 140
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City | BOERNE
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State | TX
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Zip | 78006-6503
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Country | US
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Telephone | 210-455-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 26254 INTERSTATE 10 W STE 140
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City | BOERNE
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State | TX
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Zip | 78006-6503
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Country | US
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Telephone | 210-455-0444
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Fax |
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Authorized Official
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Title or Position | OWNER/CHILD & ADOL PSYCHIATRIST
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Name | DR. JULIA JACKSON
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Credential | MD
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Telephone | 210-455-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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