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Organization
HILL COUNTRY PHYSICAL MEDICINE PLLC
Active
Organization
HILL COUNTRY PHYSICAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD ALLEN CARPENTER D.C. (CLINICAL MANAGER)
(830) 816-4357
Entity
Organization
Contact information
Practice address
1510 S MAIN STREET, BOERNE, TX 78006
(830) 816-4357
(830) 331-8718
Mailing address
1510 S MAIN STREET, BOERNE, TX 78006
(830) 816-4357
(830) 331-8718
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
Primary
—
TX
208100000X
Physical Medicine & Rehabilitation Physician
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G2G1
BCBS
TX
01
—
DV0010
RR MEDICARE PTAN
TX
Enumeration date
02/25/2014
Last updated
08/18/2015
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