Provider Demographics
NPI:1699805911
Name:HANISH, STEVEN I (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:I
Last Name:HANISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5959 HARRY HINES BLVD STE HP4.102
Mailing Address - Street 2:MAIL CODE 8567
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-6234
Mailing Address - Country:US
Mailing Address - Phone:214-645-6682
Mailing Address - Fax:214-645-6771
Practice Address - Street 1:5939 HARRY HINES BLVD STE 700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6243
Practice Address - Country:US
Practice Address - Phone:214-645-1919
Practice Address - Fax:214-645-1903
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8570204F00000X, 208600000X
MDD0075219204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0075219OtherSTATE LICENSE
TXR8570OtherTEXAS STATE LICENSE