Provider Demographics
NPI:1134491459
Name:HALBY, DANIEL W (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:HALBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 SONIA DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3246
Mailing Address - Country:US
Mailing Address - Phone:702-258-6229
Mailing Address - Fax:
Practice Address - Street 1:5524 S FORT APACHE RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-7669
Practice Address - Country:US
Practice Address - Phone:702-258-6229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV250207Q00000X
CA20A 4091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine