Provider Demographics
NPI:1225475536
Name:FEMALE HEALTH ASSOCIATES OF NORTH TEXAS, LLC
Entity Type:Organization
Organization Name:FEMALE HEALTH ASSOCIATES OF NORTH TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HANTES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-731-3936
Mailing Address - Street 1:1327 HEMPHILL STREET
Mailing Address - Street 2:SUIT 100
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104
Mailing Address - Country:US
Mailing Address - Phone:817-731-3936
Mailing Address - Fax:
Practice Address - Street 1:1327 HEMPHILL ST
Practice Address - Street 2:SUIT 100
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4735
Practice Address - Country:US
Practice Address - Phone:817-731-3936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty