Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | H3068 | TX |
NPI | 1467495325 |
---|---|
Provider Name | Dr. Kenneth Charles Hancock |
First Address | Dallas, TX 75391-1230 |
Second Address | Fort Worth, TX 76104-2154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 09/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137579201 | (05) | TX |
137579202 | (05) | TX |
137579203 | (05) | TX |
137579204 | (05) | TX |
137579205 | (05) | TX |
137579206 | (05) | TX |
137579208 | (05) | TX |
137579209 | (05) | TX |
137579210 | (05) | TX |
137579211 | (05) | TX |
137579212 | (05) | TX |
8R1454 | BLUE CROSS OF TEXAS (01) | TX |
E82895 | (02) | TX |