Provider Demographics
NPI:1194713222
Name:HANCOCK, JOSEPH E (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:MD
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 64864
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79490
Mailing Address - Country:US
Mailing Address - Phone:806-785-2045
Mailing Address - Fax:806-785-0872
Practice Address - Street 1:3502 9TH ST
Practice Address - Street 2:SUITE 360
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3300
Practice Address - Country:US
Practice Address - Phone:806-761-0747
Practice Address - Fax:806-761-0751
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8676207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114476100OtherFIRSTCARE COMMERCIAL
NM47220571Medicaid
NM53297OtherPRESBYTERIAN COMMERCIAL
TXD002OtherTRIWEST
OK100846160AMedicaid
TX114476106Medicaid
TX128124808Medicaid
TX86959XOtherHMO BLUE
TX0097JPOtherBCBS
NM53297Medicaid
TX8G6720OtherBC/BS
TX128124807Medicaid
TX128124809Medicaid
TX128124807Medicaid
TXD002OtherTRIWEST
TX128124809Medicaid
TX114476100OtherFIRSTCARE COMMERCIAL
00799UMedicare PIN