Provider Demographics
NPI:1518461870
Name:MCDANIEL, HALE (DDS)
Entity Type:Individual
Prefix:
First Name:HALE
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21007 KELLIWOOD ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6803
Mailing Address - Country:US
Mailing Address - Phone:713-822-7475
Mailing Address - Fax:
Practice Address - Street 1:6618 FM 2100 RD
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-5631
Practice Address - Country:US
Practice Address - Phone:713-906-9596
Practice Address - Fax:713-906-9596
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX180251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice