Basic Information
| Provider Information | |||||||||
| NPI: | 1912132523 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HATTER | ||||||||
| FirstName: | ALYN | ||||||||
| MiddleName: | D. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5310 HARVEST HILL RD STE 290 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752305826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144200650 | ||||||||
| FaxNumber: | 2147360512 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 WALNUT HILL DR | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756055054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037578878 | ||||||||
| FaxNumber: | 9037575985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2009 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | P3343 | TX | N | Other Service Providers | Specialist | 207N00000X | P3343 | TX | Y | Allopathic & Osteopathic Physicians | Dermatology |
ID Information
| ID | Type | State | Issuer | Description | P3343 | 01 | TX | TX MEDICAL LICENSE | OTHER |