MEDICARE: DR. ROBERT BUTLER HAMPSON PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2-1726	TX

General Provider Information

NPI Number	:	1174001960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT BUTLER HAMPSON PH.D.

Provider Business Mailing Address
First Line	:	400 W SHORE DR
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-4922
Country	:	US
Telephone Number	:	214-732-5070
Fax Number	:	214-768-1041

Provider Business Practice Location Address
First Line	:	5910 N. CENTRAL EXPRESSWAY
Second Line	:	SUITE 1820
City	:	DALLAS
State	:	TX
Zip	:	75206
Country	:	US
Telephone Number	:	214-363-2345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2018
Last Update Date	:	08/02/2018

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