Provider Demographics
NPI:1104869908
Name:HAMILTON, JULIE WATSON (PA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:WATSON
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6435 S FM 549 STE 204
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6220
Mailing Address - Country:US
Mailing Address - Phone:214-501-1410
Mailing Address - Fax:214-501-1306
Practice Address - Street 1:6435 S FM 549 STE 204
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-6220
Practice Address - Country:US
Practice Address - Phone:214-501-1410
Practice Address - Fax:214-501-1306
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02548363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8E0418OtherMEDICARE ID, UNSPECIFIED
TXS99570Medicare UPIN
TX8E0418OtherMEDICARE ID, UNSPECIFIED