Provider Demographics
NPI:1558331504
Name:HAMES, ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HAMES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4504 BOAT CLUB RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-7003
Mailing Address - Country:US
Mailing Address - Phone:817-237-0515
Mailing Address - Fax:817-237-8982
Practice Address - Street 1:4504 BOAT CLUB RD
Practice Address - Street 2:SUITE 800
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-7003
Practice Address - Country:US
Practice Address - Phone:817-237-0515
Practice Address - Fax:817-237-8982
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3010207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115677005Medicaid
TX115677005Medicaid
TXD75141Medicare UPIN