Provider Demographics
NPI:1568770501
Name:GEORGE M HALOW PA
Entity Type:Organization
Organization Name:GEORGE M HALOW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HALOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-533-6844
Mailing Address - Street 1:2311 N MESA ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3575
Mailing Address - Country:US
Mailing Address - Phone:915-533-6844
Mailing Address - Fax:915-534-7171
Practice Address - Street 1:2311 N MESA ST
Practice Address - Street 2:SUITE D
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3575
Practice Address - Country:US
Practice Address - Phone:915-533-6844
Practice Address - Fax:915-534-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4127207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000U7613Medicaid
TX089929601Medicaid
TX00AW64Medicare PIN
TXC16497Medicare UPIN