Individual provider Active NPI

Destanee Hamilton, PA

  • Physician Assistant
  • League City, TX
National Provider Identifier
1083293849
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14442 Issued in TX
Practice address
2240 Gulf Fwy S Ste 2.100
League City, TX 77573-5143
Phone
(832) 505-1600
Fax
(281) 309-0147
NPI assigned
Apr 7, 2021
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14442 TX Primary

Addresses

Primary practice location

2240 Gulf Fwy S Ste 2.100
League City, TX 77573-5143

Mailing address

1111 W Adoue St
Alvin, TX 77511-2718
Phone (281) 824-1480

Other practice location 1

1111 W Adoue St
Alvin, TX 77511-2718
Phone (281) 824-1480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210524000838 TX Practitioner - Physician Assistant 7618376765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

2240 Gulf Fwy S
League City, TX 77573-5143

2280 Gulf Fwy S
League City, TX 77573-5143

250 Blossom St
Webster, TX 77598-4241

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

PO Box
650859 Dept 710
Dallas, TX 75265-0859

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F. Austin Community Health Center, Inc. CurrentSince Jun 16, 2021 Accepting new patients
Stephen F Austin Community Health Center,Inc CurrentSince Jun 16, 2021 Accepting new patients

Locations

1111 W Adoue St
Alvin, TX 77511
Phone 2818241480 ext. 1594

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1083293849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718",
            "telephone_number": "281-824-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 GULF FWY S STE 2.100",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735143",
            "telephone_number": "832-505-1600",
            "fax_number": "281-309-0147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 W Adoue St",
            "address_purpose": "LOCATION",
            "city": "Alvin",
            "state": "TX",
            "postal_code": "775112718",
            "country_code": "US",
            "telephone_number": "281-824-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "DESTANEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.