Healthcare Provider Details

I. General information

NPI: 1194789420
Provider Name (Legal Business Name): DEBRA LYN HAMMOND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 S SONCY RD STE 150
AMARILLO TX
79119-6426
US

IV. Provider business mailing address

PO BOX 840026
DALLAS TX
75284-0026
US

V. Phone/Fax

Practice location:
  • Phone: 806-212-6353
  • Fax: 806-212-0558
Mailing address:
  • Phone: 806-212-6965
  • Fax: 806-212-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberJ8565
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: