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General NPI Number Information
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NPI Number | 1881070753
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Entity Type | Organization
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Legal Business Name | HILL COUNTRY ELECTRODIAGNOSTICS PLLC
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 155 E SONTERRA BLVD 211
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3987
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Country | US
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Telephone | 830-446-1410
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Fax |
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Provider Business Mailing Address
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Address Line | 120 BREEZE WAY
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City | BOERNE
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State | TX
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Zip | 78006-5008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | GREGORY P ERNST
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Credential | M.P.T.
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Telephone | 830-446-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1160740
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number | 1160740
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License Number State | TX
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