MEDICARE: PEDRO J HANI 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	207RP1001X	Pulmonary Disease Physician	J3114	TX
2	207RP1001X	Pulmonary Disease Physician	7694	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P000185892	OTHER	TX	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7694	OTHER	NV	MEDICAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8S3100	OTHER	TX	BC/BS

General Provider Information

NPI Number	:	1497781330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO J HANI MD

Provider Business Mailing Address
First Line	:	1701 W CHARLESTON BLVD
Second Line	:	SUITE 210
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2325
Country	:	US
Telephone Number	:	702-382-2919
Fax Number	:	702-474-0620

Provider Business Practice Location Address
First Line	:	4 SUNSET WAY
Second Line	:	SUITE A-3
City	:	HENDERSON
State	:	NV
Zip	:	89014-2015
Country	:	US
Telephone Number	:	702-434-9690
Fax Number	:	702-436-7266

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	03/06/2013

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Directions to “ PEDRO J HANI MD” Practice Location

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