Provider Demographics
NPI:1316141989
Name:HAHN, DAN WYATT (MD)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:WYATT
Last Name:HAHN
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 1:8234 STONY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-5815
Mailing Address - Country:US
Mailing Address - Phone:214-223-6300
Mailing Address - Fax:
Practice Address - Street 1:4144 N CENTRAL EXPY
Practice Address - Street 2:SUITE 360
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3140
Practice Address - Country:US
Practice Address - Phone:214-827-7460
Practice Address - Fax:214-826-6858
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0017400207L00000X
TXM9335207L00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
943038235OtherMYUTMB 943038235-COMMERCIAL NUMBER