Provider Demographics
NPI:1326423278
Name:BEREUTER, HANNAH LACHELLE (MPAS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:LACHELLE
Last Name:BEREUTER
Suffix:
Gender:F
Credentials:MPAS, PA-C
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Mailing Address - Street 1:1250 8TH AVE STE 575
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4160
Mailing Address - Country:US
Mailing Address - Phone:682-200-8580
Mailing Address - Fax:682-200-8581
Practice Address - Street 1:1250 8TH AVE STE 575
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4160
Practice Address - Country:US
Practice Address - Phone:682-200-8580
Practice Address - Fax:682-200-8581
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2020-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA09857363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant