Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D9165 | TX |
Y | 208600000X | Surgeon | D9165 | TX |
N | 2086S0129X | Vascular Surgeon | D9165 | TX |
NPI | 1023170396 |
---|---|
Provider Name | Richard B Hill |
First Address | Desoto, TX 75115-2043 |
Second Address | Desoto, TX 75115-2043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 26/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
032989801 | (05) | TX |
0612952 | AETNA HEALTH INC HMO (01) | |
4287347 | AETNA HEALTH INC PPO (01) | |
C16907 | (02) |