MEDICARE: MR. SEAN MICHAEL HANNA LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC00943	TX

General Provider Information

NPI Number	:	1093834798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEAN MICHAEL HANNA LAC

Provider Business Mailing Address
First Line	:	3355 BEE CAVE RD STE 508
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6682
Country	:	US
Telephone Number	:	512-732-1886
Fax Number	:	512-732-1887

Provider Business Practice Location Address
First Line	:	3355 BEE CAVE RD STE 508
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6682
Country	:	US
Telephone Number	:	512-732-1886
Fax Number	:	512-732-1887

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/08/2007

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