Provider Demographics
NPI:1932339868
Name:HANNA, WAEL ADEL SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:WAEL
Middle Name:ADEL SAMUEL
Last Name:HANNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1505 LBJ FWY STE 700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-6065
Mailing Address - Country:US
Mailing Address - Phone:214-358-2300
Mailing Address - Fax:214-579-6983
Practice Address - Street 1:1411 N BECKLEY AVE STE 370
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1513
Practice Address - Country:US
Practice Address - Phone:214-358-2300
Practice Address - Fax:214-579-6983
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS7227207RN0300X, 207R00000X, 207RN0300X
PAMT194179207RN0300X
PAMD446500208M00000X
AZ58743207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS7227OtherTX MEDICAL LICENSE
TXS7227OtherTX MEDICAL LICENSE