Provider Demographics
NPI:1104886811
Name:HAMM, DARREN E (MD)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:E
Last Name:HAMM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 FREDRICK LN
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-7062
Mailing Address - Country:US
Mailing Address - Phone:254-931-6665
Mailing Address - Fax:
Practice Address - Street 1:1027 FREDRICK LN
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-7062
Practice Address - Country:US
Practice Address - Phone:254-931-6665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2050207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1181570-04OtherCSHCN
TX080161801OtherRR/MEDICARE
TX1181570-02Medicaid
TX84806KOtherBLUE SHIELD
TX1181570-02Medicaid
TX84806KMedicare ID - Type Unspecified