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General NPI Number Information
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NPI Number | 1336055540
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Entity Type | Individual
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Provider Name | HENNESSEY HIILEIONALANI ELLIS CHAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 15810 MIDWAY RD
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City | ADDISON
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State | TX
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Zip | 75001-4259
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Country | US
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Telephone | 972-458-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 6315 CAMPBELL RD APT 108
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City | DALLAS
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State | TX
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Zip | 75248-1399
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Country | US
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Telephone | 808-726-0657
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | 1408903
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License Number State | TX
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