Provider Demographics
NPI:1730100660
Name:CHAUGLE, HANNAN (MD)
Entity Type:Individual
Prefix:
First Name:HANNAN
Middle Name:
Last Name:CHAUGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 W MEDICAL CENTER BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4233
Mailing Address - Country:US
Mailing Address - Phone:281-316-2612
Mailing Address - Fax:281-316-2811
Practice Address - Street 1:450 W MEDICAL CENTER BLVD STE 600
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4233
Practice Address - Country:US
Practice Address - Phone:281-316-2612
Practice Address - Fax:281-316-2811
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA970912086S0129X, 208G00000X
ORMD25493208G00000X
WAMD60036943208G00000X
TXR7414208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8455511Medicaid
WA0241714OtherLABOR & INDUSTRIES
ORH25923Medicare UPIN
WA8876510Medicare PIN