Provider Demographics
NPI:1558442293
Name:HALL, CHRISTOPHER SHANE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SHANE
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
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 227102
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-7102
Mailing Address - Country:US
Mailing Address - Phone:972-599-9600
Mailing Address - Fax:972-599-9696
Practice Address - Street 1:7300 ELDORADO PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7896
Practice Address - Country:US
Practice Address - Phone:972-599-9600
Practice Address - Fax:972-599-9696
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48698-020207Q00000X
TXM6645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX267034YM80Medicare PIN
WII49209Medicare UPIN
TX203003301Medicaid
TX8L14387Medicare PIN
WII49209Medicare UPIN
TX203003302Medicaid
TX8L14389Medicare PIN