=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487034831
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN HOWELL HAMILTON M. D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2015
-----------------------------------------------------
Last Update Date | 11/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 111 DALLAS ST
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-297-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15544 ESCARPMENT OAK
-----------------------------------------------------
City | HELOTES
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78023-5126
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-409-3481
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | R4233
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | ME165198
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------