Provider Demographics
NPI:1811147606
Name:HAMPTON CLINIC,PA
Entity type:Organization
Organization Name:HAMPTON CLINIC,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALBUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-330-9201
Mailing Address - Street 1:2301 S HAMPTON RD
Mailing Address - Street 2:STE 900
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-1650
Mailing Address - Country:US
Mailing Address - Phone:214-330-9201
Mailing Address - Fax:214-330-9209
Practice Address - Street 1:2301 S HAMPTON RD
Practice Address - Street 2:STE 900
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-1650
Practice Address - Country:US
Practice Address - Phone:214-330-9201
Practice Address - Fax:214-330-9209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty