MEDICARE: H. ANDREW HANSEN, II, MD, PA

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	E4384	TX

General Provider Information

NPI Number	:	1396918488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H. ANDREW HANSEN, II, MD, PA

Provider Business Mailing Address
First Line	:	2015 SPRING RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-3944
Country	:	US
Telephone Number	:	630-725-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	26400 KUYKENDAHL RD STE 250
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77375-2882
Country	:	US
Telephone Number	:	281-205-5990
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	CYNTHIA JONES
Credential	:
Telephone Number	:	630-725-2737

Provider Enumeration Date	:	04/09/2008
Last Update Date	:	02/08/2022

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