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General NPI Number Information
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NPI Number | 1972504884
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Entity Type | Individual
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Provider Name | THOMAS MICHAEL HILLIS MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 6412 WINDY HILL DR
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City | TEXARKANA
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State | AR
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Zip | 71854-8198
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Country | US
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Telephone | 870-330-4577
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Fax | 903-614-3525
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Provider Business Mailing Address
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Address Line | 2900 SAINT MICHAEL DR STE 307
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City | TEXARKANA
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State | TX
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Zip | 75503-2343
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Country | US
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Telephone | 903-614-5356
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Fax | 903-614-5399
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C4830
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | F4867
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License Number State | TX
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