Provider Demographics
NPI:1518907849
Name:HAMON, SHANE (MD)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:
Last Name:HAMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8311 EWING HALSELL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3741
Practice Address - Country:US
Practice Address - Phone:210-562-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60240914207L00000X
TXM3569207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP01314802OtherRR MEDICARE
WA1518907849Medicaid
WAG8925648, G8925649Medicare PIN
TXP00344351Medicare PIN
TX8G7053Medicare ID - Type UnspecifiedINIDIVDUAL MEDICARE NO.
TXI57740Medicare UPIN
TX8G7053Medicare Oscar/Certification
TXP00344351OtherRAILROAD MEDICARE-TC
TX450102C048637Medicare PIN