Healthcare Provider Details

I. General information

NPI: 1699186767
Provider Name (Legal Business Name): DARREN HYAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 ROGER BROOKE DR
JBSA FSH TX
78234-4504
US

IV. Provider business mailing address

3551 ROGER BROOKE DR
JBSA FSH TX
78234-4504
US

V. Phone/Fax

Practice location:
  • Phone: 832-721-0540
  • Fax:
Mailing address:
  • Phone: 832-721-0540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101259520
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR7484
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: