Provider Demographics
NPI:1598967135
Name:BRENDA J. HAMPTON, M.D., P.A.
Entity Type:Organization
Organization Name:BRENDA J. HAMPTON, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-530-1582
Mailing Address - Street 1:1815 OLD MILL RUN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-4214
Mailing Address - Country:US
Mailing Address - Phone:972-530-1582
Mailing Address - Fax:972-675-4959
Practice Address - Street 1:1815 OLD MILL RUN
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-4214
Practice Address - Country:US
Practice Address - Phone:972-530-1582
Practice Address - Fax:972-675-4959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2922207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F0600Medicaid