Provider Demographics
NPI:1841214251
Name:HANCE, PATRICE C
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:C
Last Name:HANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:C
Other - Last Name:VALLONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:626 WEST WHEATLAND RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116
Mailing Address - Country:US
Mailing Address - Phone:972-709-6673
Mailing Address - Fax:972-298-8590
Practice Address - Street 1:626 W WHEATLAND RD
Practice Address - Street 2:SUITE B
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116
Practice Address - Country:US
Practice Address - Phone:972-709-6673
Practice Address - Fax:972-298-8590
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02391363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA02391OtherLICENSE PERMIT