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NPI 1689663403

NPI 1689663403 : FLOYD ARTHUR HENNAN D.O. : SAN AUGUSTINE, TX

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General NPI Number Information
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    NPI Number           |    1689663403
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    Entity Type          |    Individual 
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    Provider Name        |    FLOYD ARTHUR HENNAN D.O.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/14/2005
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    Last Update Date     |    11/19/2014
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Provider Practice Location Address
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    Address Line         |    200 E LIVINGSTON ST 
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    City                 |    SAN AUGUSTINE
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    State                |    TX
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    Zip                  |    75972-2028
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    Country              |    US
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    Telephone            |    936-275-9910
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    Fax                  |    936-275-9710
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Provider Business Mailing Address
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    Address Line         |    200 E LIVINGSTON ST 
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    City                 |    SAN AUGUSTINE
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    State                |    TX
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    Zip                  |    75972-2028
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    Country              |    US
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    Telephone            |    936-275-9910
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    Fax                  |    936-275-9710
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    K9563
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    License Number State |    TX
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