Provider Demographics
NPI:1427072156
Name:HANSEN, SHANA L (MD)
Entity type:Individual
Prefix:MRS
First Name:SHANA
Middle Name:L
Last Name:HANSEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4114 POND HILL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1273
Mailing Address - Country:US
Mailing Address - Phone:210-249-5020
Mailing Address - Fax:
Practice Address - Street 1:4114 HILL ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231
Practice Address - Country:US
Practice Address - Phone:210-249-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT1957174400000X, 2080S0012X
VA0101245746174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No174400000XOther Service ProvidersSpecialist