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NPI Code Detail

MEDICARE: TRUMAN GORDON HILL II PTA

MEDICARE: TRUMAN GORDON HILL II PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2080050TX

General Provider Information

NPI Number : 1164905568
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRUMAN GORDON HILL II PTA
Provider Business Mailing Address
First Line : 608 FORREST AVE
Second Line :
City : HEREFORD
State : TX
Zip : 79045-4664
Country : US
Telephone Number : 806-206-0731
Fax Number :
Provider Business Practice Location Address
First Line : 1009 CLYDE ST
Second Line :
City : AMARILLO
State : TX
Zip : 79106-4225
Country : US
Telephone Number : 806-352-5295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2018
Last Update Date : 09/11/2018

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