Provider Demographics
NPI:1689699134
Name:HAMILTON, ELIZABETH COSTA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:COSTA
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 N IH 35 E STE 160
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5269
Mailing Address - Country:US
Mailing Address - Phone:469-800-9830
Mailing Address - Fax:
Practice Address - Street 1:2460 N IH 35 E STE 160
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5269
Practice Address - Country:US
Practice Address - Phone:469-800-9830
Practice Address - Fax:469-800-9840
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0241208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S4591OtherBCBS
TX169765802Medicaid
NV104469OtherMEDICARE PTAN
NV104469OtherMEDICARE PTAN
TX169765802Medicaid