Provider Demographics
NPI:1639147846
Name:HAMILTON, PAMELA G (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:G
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 1:3500 OAKLAWN AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4349
Mailing Address - Country:US
Mailing Address - Phone:972-709-1961
Mailing Address - Fax:972-283-1689
Practice Address - Street 1:3500 OAKLAWN AVE
Practice Address - Street 2:STE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4349
Practice Address - Country:US
Practice Address - Phone:972-709-1961
Practice Address - Fax:972-283-1689
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG74072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86X591OtherBCBS
TX00R44ZOtherMEDICARE GROUP NUMBER
TX084786501Medicaid
TX86X591Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TXD39166Medicare UPIN