Basic Information
Provider Information
NPI: 1417494303
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: TINA
MiddleName: E.
NamePrefix:  
NameSuffix:  
Credential:  
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OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 17350 ST LUKES WAY
Address2: SUITE 400
City: THE WOODLANDS
State: TX
PostalCode: 773844100
CountryCode: US
TelephoneNumber: 2814443278
FaxNumber: 8322493861
Practice Location
Address1: 17350 ST LUKES WAY
Address2: SUITE 400
City: THE WOODLANDS
State: TX
PostalCode: 773844100
CountryCode: US
TelephoneNumber: 2814443278
FaxNumber: 8322493861
Other Information
ProviderEnumerationDate: 01/30/2017
LastUpdateDate: 01/30/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XAP132357TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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