Provider Demographics
NPI:1114231743
Name:HAMPTON'S SPEECH-LANGUAGE PATHOLOGY, PLLC
Entity Type:Organization
Organization Name:HAMPTON'S SPEECH-LANGUAGE PATHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SLP
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:903-573-3540
Mailing Address - Street 1:P.O. BOX 1087
Mailing Address - Street 2:
Mailing Address - City:MT. PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75456-1087
Mailing Address - Country:US
Mailing Address - Phone:903-573-3540
Mailing Address - Fax:888-567-4527
Practice Address - Street 1:315 N. JOHNSON AVE., SUITE 102
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-3900
Practice Address - Country:US
Practice Address - Phone:903-573-3540
Practice Address - Fax:888-567-4527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101374235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195520502Medicaid
TX195520502Medicaid