Provider Demographics
NPI:1780139469
Name:HAMILTON, ORPHEUS
Entity type:Individual
Prefix:
First Name:ORPHEUS
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0533
Mailing Address - Country:US
Mailing Address - Phone:409-772-0203
Mailing Address - Fax:409-772-0088
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0533
Practice Address - Country:US
Practice Address - Phone:409-772-0203
Practice Address - Fax:409-772-0088
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129974363LG0600X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist