Provider Demographics
NPI:1982259966
Name:HAMBY, GREG
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:HAMBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 N MAJOR DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-9573
Mailing Address - Country:US
Mailing Address - Phone:409-860-0040
Mailing Address - Fax:
Practice Address - Street 1:3610 N MAJOR DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77713-9573
Practice Address - Country:US
Practice Address - Phone:409-860-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist