Individual
BRENDA A HAMILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
7310 MANCHACA RD #151617, AUSTIN, TX 78715
(512) 292-7889
(512) 292-7889
Mailing address
PO BOX 151617, AUSTIN, TX 78715
(512) 636-9641
(512) 292-7889
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
SA00075
TX
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076JR
BCBS
—
01
—
SA00075
LICENSE NUMBER
TX
Enumeration date
08/20/2006
Last updated
11/21/2015
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