Healthcare Provider Details

I. General information

NPI: 1174001960
Provider Name (Legal Business Name): ROBERT BUTLER HAMPSON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 N. CENTRAL EXPRESSWAY SUITE 1820
DALLAS TX
75206
US

IV. Provider business mailing address

400 W SHORE DR
RICHARDSON TX
75080-4922
US

V. Phone/Fax

Practice location:
  • Phone: 214-363-2345
  • Fax:
Mailing address:
  • Phone: 214-732-5070
  • Fax: 214-768-1041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2-1726
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: