MEDICARE: HILL COUNTRY ADVANCED FOOT AND ANKLE CENTER, P.A.

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1467655845	OTHER		NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467655845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILL COUNTRY ADVANCED FOOT AND ANKLE CENTER, P.A.

Provider Business Mailing Address
First Line	:	1001 MARBLE HTS
Second Line	:
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-4543
Country	:	US
Telephone Number	:	830-693-8144
Fax Number	:	830-693-8145

Provider Business Practice Location Address
First Line	:	1001 MARBLE HTS
Second Line	:
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-4543
Country	:	US
Telephone Number	:	830-693-8144
Fax Number	:	830-693-8145

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. BLAKE EVERETT JAMAIL
Credential	:
Telephone Number	:	830-693-8144

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	06/25/2009

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Directions to “HILL COUNTRY ADVANCED FOOT AND ANKLE CENTER, P.A. ” Practice Location

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