Provider Demographics
NPI:1093792293
Name:HALL, BARRETT CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:CRAIG
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:13601 PRESTON RD
Practice Address - Street 2:STE 1000W
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:972-663-8523
Practice Address - Fax:972-663-8329
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6834207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122812411Medicaid
OK200394870AMedicaid
TX122812406Medicaid
TX122812413Medicaid
TX8S5344OtherBCBS
TXP00254338OtherRAILROAD
TX122812407Medicaid
TX122812412Medicaid
TX122812414Medicaid
C36379Medicare UPIN
TXTXB111634Medicare PIN
TX8G0446Medicare PIN
TX122812406Medicaid
OK200394870AMedicaid