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:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 SIDNEY BAKER ST STE 200
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-2563
Mailing Address - Country:US
Mailing Address - Phone:210-899-6730
Mailing Address - Fax:833-776-0625
Practice Address - Street 1:2105 SIDNEY BAKER ST STE 200
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-2563
Practice Address - Country:US
Practice Address - Phone:210-899-6730
Practice Address - Fax:833-776-0625
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245746174400000X
TXT19572080S0012X, 207RS0012X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine