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NPI Code Detail

MEDICARE: MR. RYAN DOUGLAS HANKINS LAT

MEDICARE: MR. RYAN DOUGLAS HANKINS LAT
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1780882878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN DOUGLAS HANKINS LAT
Provider Business Mailing Address
First Line : PO BOX 126053
Second Line :
City : FORT WORTH
State : TX
Zip : 76126-0053
Country : US
Telephone Number : 817-249-0485
Fax Number : 817-249-3405
Provider Business Practice Location Address
First Line : 6139 CUPERTINO TRL
Second Line :
City : DALLAS
State : TX
Zip : 75252-2642
Country : US
Telephone Number : 817-249-0485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 07/10/2007

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