Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC4239TX | TX |
N | 111NR0200X | Radiology | DC4239TX | TX |
N | 213ER0200X | Radiology | DC4239TX | TX |
NPI | 1578582276 |
---|---|
Provider Name | Dr. Steven William Hanus |
First Address | Desoto, TX 75115-4013 |
Second Address | Desoto, TX 75115-4013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0065MC | BCBS/ORGANIZATION (01) | TX |
8R5372 | BLUE CROSS BLUE SHIELD (01) | TX |
DC4239TX | TX STATE LICENSE NUMBER (01) | TX |
T13678 | (02) | TX |