Provider Demographics
NPI:1063687887
Name:LUANN K HASSAN, M.D., P.A.
Entity Type:Organization
Organization Name:LUANN K HASSAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUANN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-570-5100
Mailing Address - Street 1:4301 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6416
Mailing Address - Country:US
Mailing Address - Phone:972-570-5100
Mailing Address - Fax:972-570-5556
Practice Address - Street 1:4301 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6416
Practice Address - Country:US
Practice Address - Phone:972-570-5100
Practice Address - Fax:972-570-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4195174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0033AMMedicare PIN