=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346620002
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANY HANNA D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2015
-----------------------------------------------------
Last Update Date | 09/23/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 255 LEBANON RD SUITE 112
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-327-5524
-----------------------------------------------------
Fax | 972-327-5526
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 255 LEBANON RD SUITE 112
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-327-5524
-----------------------------------------------------
Fax | 972-327-5526
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | OT016638
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | T2879
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------