Provider Demographics
NPI:1780789776
Name:HANKS, DAVID T (PHD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:HANKS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5760 LEGACY DR
Mailing Address - Street 2:S# B3-432
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7102
Mailing Address - Country:US
Mailing Address - Phone:972-596-5960
Mailing Address - Fax:972-231-9994
Practice Address - Street 1:670 W ARAPAHO RD
Practice Address - Street 2:S#9
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4200
Practice Address - Country:US
Practice Address - Phone:972-596-5960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22974103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
00N35CMedicare ID - Type Unspecified
TXR57549Medicare UPIN