Provider Demographics
NPI:1407903784
Name:HALEY, CARLTON MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:MARSHALL
Last Name:HALEY
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 1:1626 FOREST LN S STE B
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7943
Mailing Address - Country:US
Mailing Address - Phone:972-272-5591
Mailing Address - Fax:
Practice Address - Street 1:1626 FOREST LN S
Practice Address - Street 2:SUITE B
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7961
Practice Address - Country:US
Practice Address - Phone:972-272-5591
Practice Address - Fax:972-276-5413
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U85QMedicare PIN