Provider Demographics
NPI:1821186073
Name:HAMILTON, KATHLEEN G (OD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:G
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MEADOW VW
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1676
Mailing Address - Country:US
Mailing Address - Phone:361-645-7142
Mailing Address - Fax:
Practice Address - Street 1:25 MEADOW VW
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1676
Practice Address - Country:US
Practice Address - Phone:361-645-7142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6149T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist