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General NPI Number Information
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NPI Number | 1720686496
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Entity Type | Organization
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Legal Business Name | HILL COUNTRY HEALTH PLLC
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 1010 RANCH ROAD 620 S STE 107
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City | LAKEWAY
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State | TX
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Zip | 78734-5638
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Country | US
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Telephone | 217-721-0961
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 RR 620 S STE 107
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City | LAKEWAY
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State | TX
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Zip | 78734-5638
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Country | US
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Telephone | 217-721-0961
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. FATIMA HATIA
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Credential | MD
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Telephone | 309-868-1522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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