Provider Demographics
NPI:1578971834
Name:PREMIER PHYSICIANS-1 PA
Entity Type:Organization
Organization Name:PREMIER PHYSICIANS-1 PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-399-0740
Mailing Address - Street 1:9110 JORDAN LANE, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3370
Mailing Address - Country:US
Mailing Address - Phone:254-399-0740
Mailing Address - Fax:254-399-0736
Practice Address - Street 1:9110 JORDAN LANE, SUITE 100
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-3370
Practice Address - Country:US
Practice Address - Phone:254-399-0740
Practice Address - Fax:254-399-0736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty