Healthcare Provider Details

I. General information

NPI: 1194779348
Provider Name (Legal Business Name): THOMAS B. HANCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 SHULT DR SUITE 100
COLUMBUS TX
78934-3015
US

IV. Provider business mailing address

109 SHULT DR SUITE 100
COLUMBUS TX
78934-3015
US

V. Phone/Fax

Practice location:
  • Phone: 979-732-5794
  • Fax: 979-732-5795
Mailing address:
  • Phone: 979-732-5794
  • Fax: 979-732-5795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD9479
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD9479
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberD9479
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: