Provider Demographics
NPI:1568490308
Name:HEMPHILL, ROSS SEYMORE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:SEYMORE
Last Name:HEMPHILL
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 1:4112 MEK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-2711
Mailing Address - Country:US
Mailing Address - Phone:512-346-8336
Mailing Address - Fax:
Practice Address - Street 1:7000 NORTH MOPAC
Practice Address - Street 2:#180
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-482-0045
Practice Address - Fax:512-476-9892
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9691207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1176224-05Medicaid
TX117622405Medicaid
TXC16782Medicare UPIN
TX1176224-05Medicaid
TX8933J5Medicare PIN