MEDICARE: JEFFREY HILL 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
1	172V00000X	Community Health Worker	2083906	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2083906	OTHER	TX	35456042

General Provider Information

NPI Number	:	1962938688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY HILL PTA

Provider Business Mailing Address
First Line	:	6150 GLENVIEW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-9263
Country	:	US
Telephone Number	:	214-773-4787
Fax Number	:

Provider Business Practice Location Address
First Line	:	6150 GLENVIEW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-9263
Country	:	US
Telephone Number	:	214-773-4787
Fax Number	:

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

Provider Enumeration Date	:	05/02/2017
Last Update Date	:	05/02/2017

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Directions to “ JEFFREY HILL PTA” Practice Location

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