Healthcare Provider Details

I. General information

NPI: 1225214729
Provider Name (Legal Business Name): BARBARA HAMMILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 FANNIN ST
HOUSTON TX
77054-1906
US

IV. Provider business mailing address

PO BOX 588
SANTA FE TX
77510-0588
US

V. Phone/Fax

Practice location:
  • Phone: 713-790-1234
  • Fax:
Mailing address:
  • Phone: 409-925-0332
  • Fax: 409-925-1562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: