Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | H4409 | TX |
N | 207RH0002X | Hospice and Palliative Medicine | H4409 | TX |
NPI | 1396708095 |
---|---|
Provider Name | Joyce Lynette Hnatek |
First Address | Bryan, TX 77802-2623 |
Second Address | Bryan, TX 77802-2623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 11/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
111436508 | (05) | TX |
368120YSCW | MEDICARE PTAN (01) | |
E27655 | (02) |