Provider Demographics
NPI:1417976010
Name:HALL, PRISCILLA JAMES (PT)
Entity Type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:JAMES
Last Name:HALL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 FM 685 STE C3
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2913
Mailing Address - Country:US
Mailing Address - Phone:512-501-1888
Mailing Address - Fax:512-428-8189
Practice Address - Street 1:1202 FM 685 STE C3
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2913
Practice Address - Country:US
Practice Address - Phone:512-501-1888
Practice Address - Fax:512-428-8189
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPT1147205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T8757OtherBCBS
TX8K4616Medicare PIN