Provider Demographics
NPI:1053693895
Name:HILBIG, CARL (CST/CSFA)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:HILBIG
Suffix:
Gender:M
Credentials:CST/CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8302 HERALDRY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2421
Mailing Address - Country:US
Mailing Address - Phone:210-482-0250
Mailing Address - Fax:210-614-8102
Practice Address - Street 1:8302 HERALDRY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2421
Practice Address - Country:US
Practice Address - Phone:210-482-0250
Practice Address - Fax:210-614-8102
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117100246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist