Provider Demographics
NPI:1447290853
Name:HILLIARD, GEORGE D (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:D
Last Name:HILLIARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7922 EWING HALSELL DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3786
Mailing Address - Country:US
Mailing Address - Phone:210-614-7993
Mailing Address - Fax:210-692-0432
Practice Address - Street 1:7922 EWING HALSELL DR
Practice Address - Street 2:SUITE 170
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3786
Practice Address - Country:US
Practice Address - Phone:210-614-7993
Practice Address - Fax:210-692-0432
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4866207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123591306Medicaid
TXB23496Medicare UPIN
TX8133B9Medicare ID - Type Unspecified