MEDICARE: DONALD WAYNE HANSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	29890	TX

General Provider Information

NPI Number	:	1992081293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD WAYNE HANSON

Provider Business Mailing Address
First Line	:	2719 OAK LEIGH ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-4209
Country	:	US
Telephone Number	:	210-495-5504
Fax Number	:

Provider Business Practice Location Address
First Line	:	2719 OAK LEIGH ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-4209
Country	:	US
Telephone Number	:	210-857-0760
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2011
Last Update Date	:	10/31/2011

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Directions to “ DONALD WAYNE HANSON ” Practice Location

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