Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 42653 | MN |
N | 208600000X | Surgeon | 42653 | MN |
Y | 2086S0120X | Pediatric Surgery | N3067 | TX |
NPI | 1245219807 |
---|---|
Provider Name | Chad E Hamner |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TE 76104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H20476 | (02) |