Provider Demographics
NPI:1417917741
Name:HANNA, NANCY DAFASHY (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:DAFASHY
Last Name:HANNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ADIB HANNA
Other - Last Name:BISHAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1150 DEVEREUX DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573
Mailing Address - Country:US
Mailing Address - Phone:281-332-8608
Mailing Address - Fax:281-332-5283
Practice Address - Street 1:1150 DEVEREUX DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:281-332-8608
Practice Address - Fax:281-332-5283
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM07452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J1425OtherBCBS
TX187663301Medicaid
TX187663301Medicaid
8G3260Medicare PIN