Provider Demographics
NPI:1396775052
Name:HAMBY, DONNA LEAKE
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:LEAKE
Last Name:HAMBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8511 S SAM HOUSTON PKWY E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4874
Mailing Address - Country:US
Mailing Address - Phone:713-343-2301
Mailing Address - Fax:
Practice Address - Street 1:8511 S SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4874
Practice Address - Country:US
Practice Address - Phone:713-343-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX658788363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140941902Medicaid
TXS76809Medicare UPIN
TX8J9975Medicare PIN