Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | D0075219 | MD |
N | 204F00000X | Transplant Surgeon | R8570 | TX |
N | 208200000X | Surgeon | R8570 | TX |
N | 208600000X | Surgeon | R8570 | TX |
NPI | 1699805911 |
---|---|
Provider Name | Dr. Steven I. Hanish |
First Address | Dallas, TX 75235-6234 |
Second Address | Dallas, TX 75235-6243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 21/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D0075219 | STATE LICENSE (01) | MD |
R8570 | TEXAS STATE LICENSE (01) | TX |