Provider Demographics
NPI:1134693112
Name:HAMPTON SURGICAL SERVICES
Entity Type:Organization
Organization Name:HAMPTON SURGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:512-973-9222
Mailing Address - Street 1:1822 W BRAKER LN # 81603
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-3606
Mailing Address - Country:US
Mailing Address - Phone:512-973-9222
Mailing Address - Fax:512-777-4527
Practice Address - Street 1:1822 W BRAKER LN # 81603
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-3606
Practice Address - Country:US
Practice Address - Phone:512-973-9222
Practice Address - Fax:512-777-4527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00518OtherTEXAS MEDICAL BOARD