Basic Information
| Provider Information | |||||||||
| NPI: | 1396735718 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILBERT | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | RAYMOND | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HILBERT | ||||||||
| OtherFirstName: | DOUGLAS | ||||||||
| OtherMiddleName: | R. | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4410 MEDICAL DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106144000 | ||||||||
| FaxNumber: | 2146160449 | ||||||||
| Practice Location | |||||||||
| Address1: | 4410 MEDICAL DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106144000 | ||||||||
| FaxNumber: | 2106160449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2005 | ||||||||
| LastUpdateDate: | 04/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | M6656 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.