Individual
GLENN EUGENE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O,
Contact information
Practice address
2520 HARWOOD RD, SUITE 200, BEDFORD, TX 76021-6709
(817) 267-6222
Mailing address
2520 HARWOOD RD, SUITE 200, BEDFORD, TX 76021-6709
(817) 267-6222
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
H9976
TX
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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