Provider Demographics
NPI:1609080134
Name:HANSON MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:HANSON MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-451-1562
Mailing Address - Street 1:937 REINLI ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-1514
Mailing Address - Country:US
Mailing Address - Phone:512-451-1562
Mailing Address - Fax:
Practice Address - Street 1:937 REINLI ST
Practice Address - Street 2:SUITE 4
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-1514
Practice Address - Country:US
Practice Address - Phone:512-451-1562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX517567OtherBCBS OF TEXAS
TX5282400001Medicare ID - Type Unspecified