Provider Demographics
NPI:1093025827
Name:HANFORD CONSULTATIONS, P.A.
Entity Type:Organization
Organization Name:HANFORD CONSULTATIONS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-441-3230
Mailing Address - Street 1:PO BOX 65062
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79490
Mailing Address - Country:US
Mailing Address - Phone:806-441-3230
Mailing Address - Fax:
Practice Address - Street 1:4617 91ST STREET
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-441-3230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX281082201Medicaid
TXA66833Medicare UPIN