Basic Information
| Provider Information | |||||||||
| NPI: | 1700318151 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANSEN | ||||||||
| FirstName: | ALEXANDER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 720 W 34TH ST STE 110 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787051202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123467600 | ||||||||
| FaxNumber: | 5123467603 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 W 34TH ST STE 110 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787051202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123467600 | ||||||||
| FaxNumber: | 5123467603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2017 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YP0228X | T5918 | TX | N | Allopathic & Osteopathic Physicians | Otolaryngology | Pediatric Otolaryngology | 390200000X | TX | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Y00000X | T5918 | TX | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.