Hansen, Polly B

Hansen, Polly B is an individual health care provider with primary practice located at 311 Camden St Suite 208, San Antonio TX 78215-2012. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Hansen, Polly B can be contacted via phone (210) 892-0228.

Contact Information

Primary practice address
311 Camden St Suite 208 San Antonio TX 78215-2012
Phone: (210) 892-0228
Fax: (210) 455-0169
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X E14264 Texas
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X H4379 Texas

Profile Details

NPI number 1902871668
LBN Legal business name Hansen, Polly B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Mar 9th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902871668 NPPES
Texas MEDICAID 135798009

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