Individual
JEFFREY M HANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1327 HEMPHILL ST., SUITE 100, FORT WORTH, TX 76104
(817) 731-3936
(817) 782-0206
Mailing address
1327 HEMPHILL ST., SUITE 100, FORT WORTH, TX 76104
(817) 731-3936
(817) 782-0206
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
K7757
TX
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
K7757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159031701
—
TX
05
—
159031702
—
TX
05
—
159031703
—
TX
05
—
159031704
—
TX
01
—
8A8699
BCBS
TX
01
—
P00050892
RAILROAD MEDICARE PIN
TX
Enumeration date
07/30/2006
Last updated
11/29/2016
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