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General NPI Number Information
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NPI Number | 1245802933
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Entity Type | Individual
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Provider Name | MICHAEL HAMER
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Gender | Male
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 1330 E 8TH ST STE 203
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City | ODESSA
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State | TX
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Zip | 79761-4731
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Country | US
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Telephone | 832-712-1066
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 WAUGH DR # 879
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City | HOUSTON
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State | TX
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Zip | 77019-3908
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Country | US
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Telephone | 832-712-1066
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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