Provider Demographics
NPI:1851628473
Name:BRETT W HAMILTON OD PA
Entity Type:Organization
Organization Name:BRETT W HAMILTON OD PA
Other - Org Name:ROUND ROCK FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:W
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-671-9494
Mailing Address - Street 1:1 CHISHOLM TRL STE 2100
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5002
Mailing Address - Country:US
Mailing Address - Phone:512-671-9494
Mailing Address - Fax:512-671-9469
Practice Address - Street 1:1 CHISHOLM TRL STE 2100
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5002
Practice Address - Country:US
Practice Address - Phone:512-671-9494
Practice Address - Fax:512-671-9469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A5525Medicare PIN
TXV00378Medicare UPIN