Provider Demographics
NPI:1720139314
Name:HANZIK, JOLENE SONNIER (NP)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:SONNIER
Last Name:HANZIK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOLENE
Other - Middle Name:DENICE
Other - Last Name:SONNIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13820 MONTCLAIR HILL COURT
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583
Mailing Address - Country:US
Mailing Address - Phone:281-431-6771
Mailing Address - Fax:
Practice Address - Street 1:1635 NORTH LOOP WEST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008
Practice Address - Country:US
Practice Address - Phone:713-867-2000
Practice Address - Fax:713-867-2099
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX650874363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1791931Medicaid
TX1791931Medicaid
TX8G3688Medicare ID - Type Unspecified