Healthcare Provider Details

I. General information

NPI: 1154855237
Provider Name (Legal Business Name): HANNA BRADEN MCGEHEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNA MICHELLE BRADEN MD

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 AVENUE E
HONDO TX
78861-3525
US

IV. Provider business mailing address

102 PETERSBURG ST
CASTROVILLE TX
78009-4515
US

V. Phone/Fax

Practice location:
  • Phone: 830-426-7444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS4655
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: