Provider Demographics
NPI:1346475647
Name:HANNA, RIMOUN (DPT)
Entity Type:Individual
Prefix:DR
First Name:RIMOUN
Middle Name:
Last Name:HANNA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 JUSTIN RD
Mailing Address - Street 2:179
Mailing Address - City:HIGHLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75077
Mailing Address - Country:US
Mailing Address - Phone:972-808-7070
Mailing Address - Fax:972-737-1065
Practice Address - Street 1:2540 JUSTIN RD
Practice Address - Street 2:179
Practice Address - City:HIGHLAND
Practice Address - State:TX
Practice Address - Zip Code:75077
Practice Address - Country:US
Practice Address - Phone:972-808-7070
Practice Address - Fax:972-737-1065
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-16
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01366000225100000X
TX1337937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ306125Medicare PIN