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NPI Code Detail

MEDICARE: JACQUELINE HILTON O.D.

MEDICARE: JACQUELINE HILTON O.D.
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
1152W00000XOptometrist04663TTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
280760QOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1780642595
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE HILTON O.D.
Provider Business Mailing Address
First Line : 5300 NORTH ST
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75965-1370
Country : US
Telephone Number : 936-569-8278
Fax Number : 936-569-0275
Provider Business Practice Location Address
First Line : 5300 NORTH ST
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75965-1370
Country : US
Telephone Number : 936-569-8278
Fax Number : 936-569-0275
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 12/28/2007

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Directions to “ JACQUELINE HILTON O.D.” Practice Location

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