Provider Demographics
NPI:1427134998
Name:HILL COUNTRY MEMORIAL SURGERY CENTER, LLC
Entity type:Organization
Organization Name:HILL COUNTRY MEMORIAL SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBYE
Authorized Official - Middle Name:W
Authorized Official - Last Name:DOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-997-1378
Mailing Address - Street 1:204 GATEWAY N STE B
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-6361
Mailing Address - Country:US
Mailing Address - Phone:830-798-1821
Mailing Address - Fax:830-693-6452
Practice Address - Street 1:204 GATEWAY N STE B
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-6361
Practice Address - Country:US
Practice Address - Phone:830-798-1821
Practice Address - Fax:830-693-6452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007933261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1234OtherBCBS
TX156910501Medicaid
TX156910501Medicaid