Individual
POLLY B HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
311 CAMDEN ST, SUITE 208, SAN ANTONIO, TX 78215-2012
(210) 892-0228
(210) 455-0169
Mailing address
PO BOX 2947, SAN ANTONIO, TX 78299-2947
(210) 892-0228
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
E14264
TX
2085R0202X
Diagnostic Radiology Physician
Primary
H4379
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135798009
—
TX
Enumeration date
02/17/2006
Last updated
03/09/2017
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