Provider Demographics
NPI:1992024871
Name:HANNA, ANDREW EMAD (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:EMAD
Last Name:HANNA
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
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Mailing Address - Street 1:4499 MEDICAL DR STE 190
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3768
Mailing Address - Country:US
Mailing Address - Phone:210-614-3915
Mailing Address - Fax:210-614-5234
Practice Address - Street 1:4499 MEDICAL DR STE 190
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3768
Practice Address - Country:US
Practice Address - Phone:210-614-3915
Practice Address - Fax:210-614-5234
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR0011204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program