Organization
MICHELLE A HANES MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE AILEEN HANES M.D. (OWNER)
(281) 364-1014
Entity
Organization
Contact information
Practice address
1120 MEDICAL PLAZA DR, SUITE 150, SHENANDOAH, TX 77380-3242
(281) 364-1014
(281) 292-1014
Mailing address
1120 MEDICAL PLAZA DR, SUITE 150, SHENANDOAH, TX 77380-3242
(281) 364-1014
(281) 292-1014
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M1128
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176511702
—
TX
Enumeration date
12/01/2007
Last updated
09/25/2008
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