Provider Demographics
NPI:1124077284
Name:HAMNER, JANE S (MD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:S
Last Name:HAMNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5470 W. LOVERS LANE
Mailing Address - Street 2:STE 330
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209
Mailing Address - Country:US
Mailing Address - Phone:214-956-7337
Mailing Address - Fax:469-364-8724
Practice Address - Street 1:5470 W. LOVERS LANE
Practice Address - Street 2:SUITE 330
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209
Practice Address - Country:US
Practice Address - Phone:214-956-7337
Practice Address - Fax:469-364-8724
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4111208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH4111OtherMEDICAL LICENSE NUMBER
TX05-0622563OtherTAX NUMBER
TX3245HMOtherBCBS PROVIDER ID
TX4346804OtherAETNA PIN