MEDICARE: DR. ROBERT HAMES D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	E3010	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558331504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT HAMES D.O.

Provider Business Mailing Address
First Line	:	4504 BOAT CLUB RD
Second Line	:	SUITE 800
City	:	FORT WORTH
State	:	TX
Zip	:	76135-7003
Country	:	US
Telephone Number	:	817-237-0515
Fax Number	:	817-237-8982

Provider Business Practice Location Address
First Line	:	4504 BOAT CLUB RD
Second Line	:	SUITE 800
City	:	FORT WORTH
State	:	TX
Zip	:	76135-7003
Country	:	US
Telephone Number	:	817-237-0515
Fax Number	:	817-237-8982

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	12/27/2007

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