Individual
DARLA J HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMF
Contact information
Practice address
4101 E 42ND ST, ODESSA, TX 79762-7239
(432) 366-1158
(432) 366-1158
Mailing address
3302 COUNTY ROAD O, ACKERLY, TX 79713-4038
(432) 366-1158
(432) 366-1158
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
C17792
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107997-01
—
TX
01
—
103263100
FIRST CARE
TX
01
—
530030
BC/BS
TX
Enumeration date
03/16/2007
Last updated
06/17/2008
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