Provider Demographics
NPI:1598227423
Name:JUSTICE, HANNAH (MD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:JUSTICE
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 1:2828 DUKE OF GLOUCESTER ST STE 106
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2073
Mailing Address - Country:US
Mailing Address - Phone:972-298-3888
Mailing Address - Fax:972-296-0838
Practice Address - Street 1:2828 DUKE OF GLOUCESTER ST STE 106
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2073
Practice Address - Country:US
Practice Address - Phone:972-298-3888
Practice Address - Fax:972-296-0838
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT1741208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program