MEDICARE: DR. JENNIFER LYNN HANSON MD

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	207N00000X	Dermatology Physician	S8997	TX
2	207ND0101X	MOHS-Micrographic Surgery Physician	S8997	TX

General Provider Information

NPI Number	:	1326421603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER LYNN HANSON MD

Provider Business Mailing Address
First Line	:	4513 WILLIAMS DR
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78633-1302
Country	:	US
Telephone Number	:	512-930-3909
Fax Number	:	512-869-5868

Provider Business Practice Location Address
First Line	:	1610 E WHITESTONE BLVD
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-6905
Country	:	US
Telephone Number	:	512-260-3376
Fax Number	:

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

Provider Enumeration Date	:	07/03/2015
Last Update Date	:	01/16/2026

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