Basic Information
| Provider Information | |||||||||
| NPI: | 1104219732 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR. JERRON C HILL | ||||||||
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| OtherOrganizationName: | TEXAS STAR ANESTHESIA OBSTETRICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 702097 | ||||||||
| Address2: | SUITE 485 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753702097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729800500 | ||||||||
| FaxNumber: | 9729800503 | ||||||||
| Practice Location | |||||||||
| Address1: | 4101 MCEWEN RD | ||||||||
| Address2: | SUITE 485 | ||||||||
| City: | FARMERS BRANCH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752445112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729800500 | ||||||||
| FaxNumber: | 9729800503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2015 | ||||||||
| LastUpdateDate: | 06/01/2015 | ||||||||
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| AuthorizedOfficialLastName: | HILL | ||||||||
| AuthorizedOfficialFirstName: | JERRON | ||||||||
| AuthorizedOfficialMiddleName: | CARLYLE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2144374801 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | L4969 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.