Provider Demographics
NPI:1699194290
Name:HNATOW, TIFFANY (MD)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:HNATOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:TIFFANY
Other - Middle Name:PHUONG
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6770
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-6770
Mailing Address - Country:US
Mailing Address - Phone:361-883-2000
Mailing Address - Fax:361-561-1355
Practice Address - Street 1:6118 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2455
Practice Address - Country:US
Practice Address - Phone:361-883-2000
Practice Address - Fax:361-561-1355
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0022208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics