Provider Demographics
NPI:1104458405
Name:HANCE, CAROL A
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:HANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11565 S HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-4932
Mailing Address - Country:US
Mailing Address - Phone:281-340-1504
Mailing Address - Fax:281-340-1507
Practice Address - Street 1:11565 S HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4932
Practice Address - Country:US
Practice Address - Phone:281-340-1504
Practice Address - Fax:281-340-1507
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1835P0018XOtherPHARMACY