Provider Demographics
NPI:1992763262
Name:HAMILTON, REKHA BALLA (MD)
Entity type:Individual
Prefix:DR
First Name:REKHA
Middle Name:BALLA
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REKHA
Other - Middle Name:HAMILTON
Other - Last Name:BALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7908 ADOBE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-4606
Mailing Address - Country:US
Mailing Address - Phone:817-927-6252
Mailing Address - Fax:817-922-2327
Practice Address - Street 1:1400 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4110
Practice Address - Country:US
Practice Address - Phone:817-927-6259
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM26342080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine