Provider Demographics
NPI:1801954011
Name:HAMMOND, DEANNA ANGELA (OD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:ANGELA
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DEANNA
Other - Middle Name:ANGELA
Other - Last Name:LYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2634 S CARRIER PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-5070
Mailing Address - Country:US
Mailing Address - Phone:972-641-0011
Mailing Address - Fax:972-641-8206
Practice Address - Street 1:2634 S CARRIER PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-5070
Practice Address - Country:US
Practice Address - Phone:972-641-0011
Practice Address - Fax:972-641-8206
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2557T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81389QOtherBCBS
TX75-1726552OtherUNITED HEALTH CARE