Organization Name: | INGLESIDE MEDICAL & AESTHETICS PLLC |
NPI Number: | 1427431329 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIMOTHY GEORGE HILL (DDS/GENERAL DENTIST) |
Mailing Address: | 2681 Hwy 361 Ingleside |
State: | TX US |
Postal Code: | 783624200 |
Phone Number: | 3617763500 |
Fax Number: | 8667662629 |
NPI Enumeration Date: | 07/09/2015 |
NPI Last Update Date: | 07/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |