Provider Demographics
NPI:1780882878
Name:HANKINS, RYAN DOUGLAS (LAT)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:DOUGLAS
Last Name:HANKINS
Suffix:
Gender:M
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 126053
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76126-0053
Mailing Address - Country:US
Mailing Address - Phone:817-249-0485
Mailing Address - Fax:817-249-3405
Practice Address - Street 1:6139 CUPERTINO TRL
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-2642
Practice Address - Country:US
Practice Address - Phone:817-249-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies