Provider Demographics
NPI:1376524348
Name:HANKINS, ALTON BENTON (MD)
Entity Type:Individual
Prefix:
First Name:ALTON
Middle Name:BENTON
Last Name:HANKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7039
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79708-7039
Mailing Address - Country:US
Mailing Address - Phone:432-620-8500
Mailing Address - Fax:432-620-8501
Practice Address - Street 1:10 DESTA DR
Practice Address - Street 2:STE 220 W.
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-4515
Practice Address - Country:US
Practice Address - Phone:432-620-8500
Practice Address - Fax:432-620-8501
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE09542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000AH914Medicaid
TXE0954OtherSTATE LIC
TXAH5527479OtherDEA #
TXC16548Medicare UPIN
TXP000AH914Medicaid