MEDICARE: PHYSICIANS HEALTHY HUB

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1700714342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS HEALTHY HUB

Provider Business Mailing Address
First Line	:	24115 IVORY SUNSET LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-3247
Country	:	US
Telephone Number	:	772-485-9994
Fax Number	:

Provider Business Practice Location Address
First Line	:	4818 W US HIGHWAY 90 STE 100
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-8397
Country	:	US
Telephone Number	:	772-485-9994
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES O HILL
Credential	:	DO
Telephone Number	:	772-485-9994

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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Directions to “PHYSICIANS HEALTHY HUB ” Practice Location

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