MEDICARE: TOM DANIEL HILL MD

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	207Q00000X	Family Medicine Physician	H9218	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0036CU	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1639116338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOM DANIEL HILL MD

Provider Business Mailing Address
First Line	:	4030 SAM HOUSTON AVE
Second Line	:	STE A
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340
Country	:	US
Telephone Number	:	936-291-9006
Fax Number	:	936-291-3128

Provider Business Practice Location Address
First Line	:	4030 SAM HOUSTON AVE
Second Line	:	STE A
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340
Country	:	US
Telephone Number	:	936-291-9006
Fax Number	:	936-291-3128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	01/24/2008

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Directions to “ TOM DANIEL HILL MD” Practice Location

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