Provider Demographics
NPI:1811365265
Name:HAN, JASON C (PT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:C
Last Name:HAN
Suffix:
Gender:M
Credentials:PT
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Other - First Name:
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Mailing Address - Street 1:4951 LONG PRAIRIE RD
Mailing Address - Street 2:110
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2707
Mailing Address - Country:US
Mailing Address - Phone:972-410-5777
Mailing Address - Fax:972-410-5778
Practice Address - Street 1:4951 LONG PRAIRIE RD
Practice Address - Street 2:110
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2707
Practice Address - Country:US
Practice Address - Phone:972-410-5777
Practice Address - Fax:972-410-5778
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2016-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1237249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX439785YTNBOtherMEDICARE PTAN