Provider Demographics
NPI:1487657821
Name:HENSEL, JOANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANN
Middle Name:
Last Name:HENSEL
Suffix:
Gender:F
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 7160
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77726-7160
Mailing Address - Country:US
Mailing Address - Phone:409-838-3725
Mailing Address - Fax:409-838-4824
Practice Address - Street 1:3129 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4660
Practice Address - Country:US
Practice Address - Phone:409-838-3725
Practice Address - Fax:409-838-4824
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2090207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131604404Medicaid
TXB89753Medicare UPIN
TX80814GMedicare PIN