Provider Demographics
NPI:1417929563
Name:MARTIN, HAL DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:HAL
Middle Name:DAVID
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3900 JUNIUS ST STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1621
Mailing Address - Country:US
Mailing Address - Phone:214-820-9520
Mailing Address - Fax:214-820-9516
Practice Address - Street 1:411 N WASHINGTON AVE
Practice Address - Street 2:SUITE 7300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:214-820-9520
Practice Address - Fax:214-820-9516
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2934207X00000X
TXP2144207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1760488936OtherGROUP NPI
TXOON85XOtherMEDICARE GROUP
OKP00040307OtherRAILROAD MEDICARE
OK100101910BMedicaid
TXP01127057OtherRAILROAD MEDICARE
OK100101910BMedicaid
TX271446YKY6Medicare PIN
OKP00040307OtherRAILROAD MEDICARE