Provider Demographics
NPI:1952432460
Name:HAMILTON, JEFFREY RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:RAY
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13306 LAKESIDE TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-5242
Mailing Address - Country:US
Mailing Address - Phone:713-927-6126
Mailing Address - Fax:
Practice Address - Street 1:13306 LAKESIDE TERRACE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-5242
Practice Address - Country:US
Practice Address - Phone:713-927-6126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7910111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC 7910OtherCHIROPRACTIC LICENSE NUM.