Dr Sullivan Clyde Hanback, MD is a
Student In An Organized Health Care Education/training Program physician based in Houston, Texas. Dr Sullivan Clyde Hanback is licensed to practice in * (Not Available) (license number ) and his current practice location is 6431 Fannin Street, Suite Jjl 270-6, Houston, Texas. He can be reached at his office (for appointments etc.) via phone at
(713) 500-7878.
NPI number for Dr Sullivan Clyde Hanback is 1417538141 and his current mailing address is 6431 Fannin Street, Suite Jjl 270-6, Houston, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417538141.
Physician's Profile
| Full Name | Dr Sullivan Clyde Hanback |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 6431 Fannin Street, Houston, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1417538141
- Provider Enumeration Date: 04/15/2021
- Last Update Date: 06/30/2023
Medical Identifiers
Medical identifiers for Dr Sullivan Clyde Hanback such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417538141 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | U4523 (Texas) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Sullivan Clyde Hanback is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Sullivan Clyde Hanback, MD
6431 Fannin Street, Suite Jjl 270-6,
Houston, TX 77030
Ph: (713) 500-7878 | Dr Sullivan Clyde Hanback, MD
6431 Fannin Street, Suite Jjl 270-6,
Houston, TX 77030
Ph: (713) 500-7878 |
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