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1346230810

NPI Code Detail

MEDICARE: PHILLIP E HANSEN MD

MEDICARE: PHILLIP E HANSEN 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	207XS0106X	Orthopaedic Hand Surgery Physician	F1619	TX
2	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	F1619	TX
3	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	F1619	TX
4	207XX0801X	Orthopaedic Trauma Physician	F1619	TX
5	207X00000X	Orthopaedic Surgery Physician	F1619	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	840760	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346230810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP E HANSEN MD

Provider Business Mailing Address
First Line	:	3900 JUNIUS ST
Second Line	:	SUITE 500
City	:	DALLAS
State	:	TX
Zip	:	75246-1615
Country	:	US
Telephone Number	:	469-800-7200
Fax Number	:	469-800-7210

Provider Business Practice Location Address
First Line	:	3900 JUNIUS ST
Second Line	:	SUITE 500
City	:	DALLAS
State	:	TX
Zip	:	75246-1615
Country	:	US
Telephone Number	:	469-800-7200
Fax Number	:	469-800-7210

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	05/31/2023

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Directions to “ PHILLIP E HANSEN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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