Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | E4852 | TX |
NPI | 1033179213 |
---|---|
Provider Name | Dr. John Kent Hamilton |
First Address | Dallas, TX 75247-4228 |
Second Address | Dallas, TX 75246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 25/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102733601 | (05) | TX |
83Y788 | BCBSTX (01) | TX |
C16512 | (02) | TX |