Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | E4384 | TX |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD20040113 | NM |
NPI | 1104881945 |
---|---|
Provider Name | Henry Andrew Hansen II |
First Address | Oak Brook, IL 60523-3944 |
Second Address | The Woodlands, TX 77375-2882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 08/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0A3513 | GROUP MEDICARE PTAN (01) | TX |
128605607 | (05) | TX |
340731 | GROUP MEDICARE PTAN (01) | TX |
340739 | GROUP MEDICARE PTAN (01) | TX |
DV0090 | MEDICARE RAILROAD GROUP PTAN (01) | TX |
P01671333 | MEDICARE RAILROAD INDIVIDUAL PTAN (01) | TX |