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NPI Code Detail

MEDICARE: DR. RITA GLYNN HAMILTON D.O.

MEDICARE: DR. RITA GLYNN HAMILTON 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
1208100000XPhysical Medicine & Rehabilitation PhysicianK0805TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28BR093OTHERTXBCBS

General Provider Information

NPI Number : 1730197450
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RITA GLYNN HAMILTON D.O.
Provider Business Mailing Address
First Line : 909 N WASHINGTON AVE
Second Line :
City : DALLAS
State : TX
Zip : 75246-1520
Country : US
Telephone Number : 214-820-9637
Fax Number : 214-820-9339
Provider Business Practice Location Address
First Line : 909 N WASHINGTON AVE
Second Line :
City : DALLAS
State : TX
Zip : 75246-1520
Country : US
Telephone Number : 214-820-9637
Fax Number : 214-820-9339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 02/01/2011

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