Provider Demographics
NPI:1528115185
Name:S.L. HANKINSON
Entity type:Organization
Organization Name:S.L. HANKINSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMERTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MADLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-689-0444
Mailing Address - Street 1:3415 ANDREWS HWY
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-5149
Mailing Address - Country:US
Mailing Address - Phone:432-689-0444
Mailing Address - Fax:432-699-0937
Practice Address - Street 1:3415 ANDREWS HWY
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-5149
Practice Address - Country:US
Practice Address - Phone:432-689-0444
Practice Address - Fax:432-699-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3346TG152W00000X
TX6769TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0032FGOtherBCBS MID
TX178620401Medicaid
TX0526300001Medicare NSC
TXTXB103331Medicare PIN