Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | L4423 | TX |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | L4423 | TX |
NPI | 1780666024 |
---|---|
Provider Name | Travis W Hanson |
First Address | Houston, TX 77070-4347 |
Second Address | Houston, TX 77070-4347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 24/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163086502 | (05) | TX |
163086503 | (05) | TX |
1780666024 | BLUE CROSS BLUE SHIELD (01) | TX |
601771109 | US DEPT OF LABOR (01) | |
610197301 CENTERFIEL | US DEPT OF LABOR (01) | TX |
610197302 FANNIN | US DEPT OF LABOR (01) | TX |
616771101 | US DEPT OF LABOR (01) | |
616771105 | US DEPT OF LABOR (01) | |
616771110 | US DEPT OF LABOR (01) | |
8DY868 | BLUE CROSS BLUE SHIELD (01) | TX |
P00931461 | MEDICARE RR (01) | TX |
P01055683 | RR MEDICARE (01) | TX |
P01258265 | MEDICARE RR (01) | TX |