Provider Demographics
NPI:1164478418
Name:HASSAN JONES, LYNN BAKEERAH (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:BAKEERAH
Last Name:HASSAN JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:BAKEERAH
Other - Last Name:HASSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1845 PRECINCT LINE RD STE 209
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3109
Mailing Address - Country:US
Mailing Address - Phone:817-632-5803
Mailing Address - Fax:817-632-5803
Practice Address - Street 1:1845 PRECINCT LINE RD STE 209
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3109
Practice Address - Country:US
Practice Address - Phone:817-632-5803
Practice Address - Fax:817-632-5803
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN340102085R0202X
TXPENDING2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology