Individual
DR. KENNETH CHARLES HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 S HENDERSON ST STE 200, FORT WORTH, TX 76104-2154
(174) 131-5008
(817) 413-1499
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
H3068
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137579201
—
TX
05
—
137579202
—
TX
05
—
137579203
—
TX
05
—
137579204
—
TX
05
—
137579205
—
TX
05
—
137579206
—
TX
05
—
137579208
—
TX
05
—
137579209
—
TX
05
—
137579210
—
TX
05
—
137579211
—
TX
05
—
137579212
—
TX
01
—
8R1454
BLUE CROSS OF TEXAS
TX
Enumeration date
06/14/2006
Last updated
12/09/2021
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