Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | N6479 | TX |
NPI | 1003010893 |
---|---|
Provider Name | Andrea S Hatchette |
First Address | Carrollton, TX 75010-4620 |
Second Address | Carrollton, TX 75010-4620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 21/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
216780101 | (05) | TX |
216780102 | (05) | TX |
216780103 | (05) | TX |
BP1-0027249 | INSTITUTIONAL PERMIT (01) |