Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 257505 | TX |
NPI | 1053475038 |
---|---|
Provider Name | Eva M. Hannin |
First Address | Dallas, TX 75266-0599 |
Second Address | Garland, TX 75040-7379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 08/07/2007 |