Provider Demographics
NPI:1053857128
Name:HACKER, DANIEL (PMHNP-BC, FNP-C)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HACKER
Suffix:
Gender:M
Credentials:PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18965 FM 2252 STE 208
Mailing Address - Street 2:
Mailing Address - City:GARDEN RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:78266-2700
Mailing Address - Country:US
Mailing Address - Phone:210-549-9997
Mailing Address - Fax:855-710-7605
Practice Address - Street 1:18965 FM 2252 STE 208
Practice Address - Street 2:
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2700
Practice Address - Country:US
Practice Address - Phone:210-549-9997
Practice Address - Fax:855-710-7605
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131356363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily