Provider Demographics
NPI:1558742924
Name:HAMPTON MEDICAL CLINIC MANAGEMENT LLC
Entity Type:Organization
Organization Name:HAMPTON MEDICAL CLINIC MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-345-6464
Mailing Address - Street 1:4373 S HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-1058
Mailing Address - Country:US
Mailing Address - Phone:214-339-9359
Mailing Address - Fax:214-339-7326
Practice Address - Street 1:4373 S HAMPTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-1058
Practice Address - Country:US
Practice Address - Phone:214-339-9359
Practice Address - Fax:214-339-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service