Provider Demographics
NPI:1407826316
Name:HAMPTON, EARL S (MD)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:S
Last Name:HAMPTON
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:PO BOX 120069
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012
Mailing Address - Country:US
Mailing Address - Phone:817-274-1999
Mailing Address - Fax:817-274-4671
Practice Address - Street 1:4927 S COLLINS ST STE 107
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1167
Practice Address - Country:US
Practice Address - Phone:817-465-1171
Practice Address - Fax:817-465-6044
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5561208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098144101Medicaid