Provider Demographics
NPI:1437177540
Name:HALL, DAVID BERT (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BERT
Last Name:HALL
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:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-0226
Mailing Address - Country:US
Mailing Address - Phone:940-464-3066
Mailing Address - Fax:
Practice Address - Street 1:325 OLD JUSTIN RD
Practice Address - Street 2:BOX 226
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-3514
Practice Address - Country:US
Practice Address - Phone:972-934-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2867207P00000X
TXL0239207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0068PJOtherBCBS
TX141964012Medicaid
TX141964014Medicaid
TX8F7254OtherBCBS
TX612887Medicare PIN
OKF09369Medicare UPIN
TX141964014Medicaid
TXP00456110Medicare PIN
TX141964012Medicaid