Provider Demographics
NPI:1568625150
Name:PAUL M HAMILTON PHD PC
Entity Type:Organization
Organization Name:PAUL M HAMILTON PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-727-0143
Mailing Address - Street 1:PO BOX 2221
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78381-2221
Mailing Address - Country:US
Mailing Address - Phone:361-727-0143
Mailing Address - Fax:361-727-2036
Practice Address - Street 1:101 N MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-2748
Practice Address - Country:US
Practice Address - Phone:361-727-0143
Practice Address - Fax:361-727-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26879103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031290201Medicaid
TX0086BTMedicare PIN
TX031290201Medicaid