Provider Demographics
NPI:1346295185
Name:HAMBURG, SOL (MD)
Entity Type:Individual
Prefix:
First Name:SOL
Middle Name:
Last Name:HAMBURG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7155 OLD KATY RD
Mailing Address - Street 2:N100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2134
Mailing Address - Country:US
Mailing Address - Phone:713-668-6828
Mailing Address - Fax:832-280-3636
Practice Address - Street 1:12121 RICHMOND AVE STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2422
Practice Address - Country:US
Practice Address - Phone:713-558-8775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4008207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033664604Medicaid
TX00GU49Medicare ID - Type Unspecified
TX0336646-01Medicaid