Provider Demographics
NPI:1639225857
Name:HAMMONDS, BASIMMA F
Entity Type:Individual
Prefix:
First Name:BASIMMA
Middle Name:F
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6407 FAIR VALLEY TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1611
Mailing Address - Country:US
Mailing Address - Phone:512-563-5025
Mailing Address - Fax:
Practice Address - Street 1:2712 BEE CAVES RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5676
Practice Address - Country:US
Practice Address - Phone:512-732-2220
Practice Address - Fax:512-732-2227
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11518822251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T2275OtherBLUE CROSS BLUE SHIELD
TX8T3298OtherBLUE CROSS BLUE SHIELD
TXTXB100501Medicare PIN
TX8T3298OtherBLUE CROSS BLUE SHIELD
TX8K2129Medicare PIN
TXTXB100506Medicare PIN