MEDICARE: MRS. SHANA L HANSEN M.D.

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	174400000X	Specialist	0101245746	VA
2	174400000X	Specialist	T1957	TX
3	2080S0012X	Pediatric Sleep Medicine Physician	T1957	TX

General Provider Information

NPI Number	:	1427072156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANA L HANSEN M.D.

Provider Business Mailing Address
First Line	:	2105 SIDNEY BAKER ST STE 200
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-2563
Country	:	US
Telephone Number	:	210-899-6730
Fax Number	:	833-776-0625

Provider Business Practice Location Address
First Line	:	2105 SIDNEY BAKER ST STE 200
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-2563
Country	:	US
Telephone Number	:	210-899-6730
Fax Number	:	833-776-0625

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	01/02/2026

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