Provider Demographics
NPI:1932282019
Name:HANDLEY, JOHN DUNLOP (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DUNLOP
Last Name:HANDLEY
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 1:4632 NASA PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-5414
Mailing Address - Country:US
Mailing Address - Phone:281-326-5525
Mailing Address - Fax:281-326-2590
Practice Address - Street 1:4632 NASA PKWY
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:TX
Practice Address - Zip Code:77586-5414
Practice Address - Country:US
Practice Address - Phone:281-326-5525
Practice Address - Fax:281-326-2590
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COG9748207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00K07NOtherBSBC PROVIDER ID
TXP00447175OtherMEDICARE RAILROAD PTAN
TX1932282019OtherNPI
TX419857OtherWELLCARE
TXC16543OtherUPIN
TX00K07NMedicare PIN