Provider Demographics
NPI:1427431329
Name:INGLESIDE MEDICAL & AESTHETICS PLLC
Entity type:Organization
Organization Name:INGLESIDE MEDICAL & AESTHETICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:361-776-3500
Mailing Address - Street 1:2681 HWY 361
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362-4200
Mailing Address - Country:US
Mailing Address - Phone:361-776-3500
Mailing Address - Fax:866-766-2629
Practice Address - Street 1:2681 HWY 361
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362-4200
Practice Address - Country:US
Practice Address - Phone:361-776-3500
Practice Address - Fax:866-766-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care