Provider Demographics
NPI:1407853666
Name:HALABY, GERALD ALLAN (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:ALLAN
Last Name:HALABY
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 2248
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-2248
Mailing Address - Country:US
Mailing Address - Phone:281-770-3626
Mailing Address - Fax:281-256-0983
Practice Address - Street 1:13602 WAVERLY CREST CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6830
Practice Address - Country:US
Practice Address - Phone:281-770-3626
Practice Address - Fax:281-256-0983
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-02
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3158207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000JJ471Medicaid
TX00JJ47Medicare ID - Type Unspecified
TXP000JJ471Medicaid