Provider Demographics
NPI:1194779348
Name:HANCHER, THOMAS B (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:B
Last Name:HANCHER
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 1:109 SHULT DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934-3015
Mailing Address - Country:US
Mailing Address - Phone:979-732-5794
Mailing Address - Fax:979-732-5795
Practice Address - Street 1:109 SHULT DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-3015
Practice Address - Country:US
Practice Address - Phone:979-732-5794
Practice Address - Fax:979-732-5795
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9479207R00000X, 207P00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453415Medicare ID - Type Unspecified
TXB23294Medicare UPIN