Provider Demographics
NPI:1912386970
Name:HANRAHAN, COREY (DO,)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:
Last Name:HANRAHAN
Suffix:
Gender:M
Credentials:DO,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 24TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1815
Mailing Address - Country:US
Mailing Address - Phone:806-792-2767
Mailing Address - Fax:888-861-8858
Practice Address - Street 1:4005 24TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1815
Practice Address - Country:US
Practice Address - Phone:806-792-2767
Practice Address - Fax:888-861-8858
Is Sole Proprietor?:No
Enumeration Date:2015-05-23
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT016631207R00000X
TXS96972085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine