1194713222 NPI number — JOSEPH E HANCOCK M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194713222 NPI number — JOSEPH E HANCOCK M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

HANCOCK

Provider First Name:

JOSEPH

Provider Middle Name:

E

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1194713222

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/09/2014

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 64864

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LUBBOCK

Provider Business Mailing Address State Name:

TX

Provider Business Mailing Address Postal Code:

79490

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

806-785-2045

Provider Business Mailing Address Fax Number:

806-785-0872

Provider First Line Business Practice Location Address:

3502 9TH ST

Provider Second Line Business Practice Location Address:

SUITE 360

Provider Business Practice Location Address City Name:

LUBBOCK

Provider Business Practice Location Address State Name:

TX

Provider Business Practice Location Address Postal Code:

79415-3300

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

806-761-0747

Provider Business Practice Location Address Fax Number:

806-761-0751

Provider Enumeration Date:

10/12/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207RG0100X , with the licence number:  H8676 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 114476100 . This is a "FIRSTCARE COMMERCIAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 47220571 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: 53297 . This is a "PRESBYTERIAN COMMERCIAL" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: D002 . This is a "TRIWEST" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 100846160A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
• Identifier: 114476106 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 128124808 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 86959X . This is a "HMO BLUE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 0097JP . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 53297 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: 8G6720 . This is a "BC/BS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 128124807 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 128124809 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".