Organization Name: | M.K. HAMZA PH.D., P.A. |
NPI Number: | 1346434750 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | M.K. HAMZA (OWNER) |
Mailing Address: | 2300 Highway 365 Ste 110 Nederland |
State: | TX US |
Postal Code: | 776276256 |
Phone Number: | 4097290400 |
Fax Number: | 4097290453 |
NPI Enumeration Date: | 08/29/2007 |
NPI Last Update Date: | 10/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 33373 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |