Provider Demographics
NPI:1841637030
Name:HAMILTON, RACHEL GAMBULOS (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:GAMBULOS
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:GAMBULOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:1108 S HENDERSON ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4430
Practice Address - Country:US
Practice Address - Phone:817-335-3255
Practice Address - Fax:817-338-9563
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0045911208000000X
TXQ6630208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics