Provider Demographics
NPI:1437103652
Name:HAWAYEK, LANA H (M D)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:H
Last Name:HAWAYEK
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:106 VISION PARK BLVD
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3000
Practice Address - Country:US
Practice Address - Phone:713-442-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4461207N00000X
OHPENDING207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343887101Medicaid
TX343887101Medicaid
OHP00405428OtherRR MEDICARE
TX343887101Medicaid
TXTXB115273Medicare PIN
OH2684386Medicaid
OHHA4187934Medicare PIN
OHHA4187933Medicare PIN
TX379636YKTXMedicare PIN
OHI57091Medicare UPIN