Provider Demographics
NPI:1972733996
Name:TARTIBI, HANA MARYAM (MD)
Entity Type:Individual
Prefix:
First Name:HANA
Middle Name:MARYAM
Last Name:TARTIBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 SCRIPTURE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2398
Mailing Address - Country:US
Mailing Address - Phone:940-382-4142
Mailing Address - Fax:940-382-7620
Practice Address - Street 1:2617 SCRIPTURE ST STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2398
Practice Address - Country:US
Practice Address - Phone:940-382-4142
Practice Address - Fax:940-382-7620
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3083208M00000X, 207R00000X, 207K00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program