Provider Demographics
NPI:1477732600
Name:HALLMAN, SUE D (LDT)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:D
Last Name:HALLMAN
Suffix:
Gender:F
Credentials:LDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 RUNNELS ST
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-2527
Mailing Address - Country:US
Mailing Address - Phone:432-264-2650
Mailing Address - Fax:432-268-9897
Practice Address - Street 1:114 LOCUST ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-4552
Practice Address - Country:US
Practice Address - Phone:432-264-2650
Practice Address - Fax:432-268-9897
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2610133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered