Provider Demographics
NPI:1346441581
Name:HANNA, ISSA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ISSA
Middle Name:
Last Name:HANNA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10905 MEMORIAL HERMANN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3490
Mailing Address - Country:US
Mailing Address - Phone:336-420-0534
Mailing Address - Fax:
Practice Address - Street 1:10905 MEMORIAL HERMANN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3490
Practice Address - Country:US
Practice Address - Phone:336-420-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC77721223S0112X
TX248931223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery