Doctor Name: | MRS. MARY FAYE HANSON |
NPI Number: | 1245520642 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 201000215992 |
Business Practice Address: | 722 E Cherry St Duncanville, TX - 751164015 |
Business Phone Number: | 8175079315 |
Business Fax Number: | 2146668482 |
Mailing Address: | 722 E Cherry St, DUNCANVILLE |
State: | TX |
Postal Code: | 751164015 |
Phone Number: | 8175079315 |
Fax Number: | 2146668482 |
NPI Enumeration Date: | 04/19/2011 |
NPI Last Update Date: | 04/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | 201000215992 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |