Basic Information
| Provider Information | |||||||||
| NPI: | 1003016718 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HRNACK | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | ALLAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1149 KELLER PKWY STE A | ||||||||
| Address2: | |||||||||
| City: | KELLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762481620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175621040 | ||||||||
| FaxNumber: | 8175621043 | ||||||||
| Practice Location | |||||||||
| Address1: | 1149 KELLER PKWY STE A | ||||||||
| Address2: | |||||||||
| City: | KELLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762481620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175621040 | ||||||||
| FaxNumber: | 8175621043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2007 | ||||||||
| LastUpdateDate: | 08/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | M7280 | TX | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8KW883 | 01 | TX | BCBS | OTHER | P02247588 | 01 | TX | RAILROAD MEDICARE | OTHER | 219943201 | 05 | TX | MEDICAID | 804333 | 01 | TX | MEDICARE PIN | OTHER | 8CL990 | 01 | TX | BCBS | OTHER |