MEDICARE: MS. FRANCES ANN HANSEN PT, OCS

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	225100000X	Physical Therapist	1152520	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8T3281	OTHER	TX	BLUE CROSS/ BLUE SHIELD

General Provider Information

NPI Number	:	1407960727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FRANCES ANN HANSEN PT, OCS

Provider Business Mailing Address
First Line	:	PO BOX 670769
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75367-0769
Country	:	US
Telephone Number	:	214-239-0990
Fax Number	:	214-239-0991

Provider Business Practice Location Address
First Line	:	7115 GREENVILLE AVE
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75231-5100
Country	:	US
Telephone Number	:	214-239-0990
Fax Number	:	214-239-0991

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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