Basic Information
Provider Information
NPI: 1568764793
EntityType: 2
ReplacementNPI:  
OrganizationName: HILLCREST BAPTIST MEDICAL CENTER
LastName:  
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Mailing Information
Address1: 100 HILLCREST MEDICAL BLVD
Address2:  
City: WACO
State: TX
PostalCode: 767128897
CountryCode: US
TelephoneNumber: 2542022000
FaxNumber:  
Practice Location
Address1: 100 HILLCREST MEDICAL BLVD
Address2:  
City: WACO
State: TX
PostalCode: 767128897
CountryCode: US
TelephoneNumber: 2542022000
FaxNumber: 2542023949
Other Information
ProviderEnumerationDate: 11/19/2010
LastUpdateDate: 11/19/2010
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: OWENS
AuthorizedOfficialFirstName: SOMMER
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AuthorizedOfficialTitleorPosition: NUTRITION MANAGER
AuthorizedOfficialTelephone: 2542023952
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MS, RD, LD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X1048458TXY HospitalsGeneral Acute Care Hospital 

No ID Information.


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