Provider Demographics
NPI:1295973923
Name:HAMARQ, PA
Entity type:Organization
Organization Name:HAMARQ, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:MARQUEZ
Authorized Official - Last Name:HAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-999-1019
Mailing Address - Street 1:2811 MCKINNEY AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2628
Mailing Address - Country:US
Mailing Address - Phone:214-999-1019
Mailing Address - Fax:214-999-1051
Practice Address - Street 1:2811 MCKINNEY AVE STE 240
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:214-999-1019
Practice Address - Fax:214-999-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9515261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care