Provider Demographics
NPI:1336380310
Name:WYNDHAM HANNERS, NATASHA L (MD)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:L
Last Name:WYNDHAM HANNERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:L
Other - Last Name:WYNDHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-456-6500
Mailing Address - Fax:214-648-2961
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7208
Practice Address - Country:US
Practice Address - Phone:214-456-6500
Practice Address - Fax:214-648-2961
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP33382080P0208X, 2080P0207X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program