Provider Demographics
NPI:1578672333
Name:HAL D HUFFMAN MD PA
Entity Type:Organization
Organization Name:HAL D HUFFMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:940-521-5500
Mailing Address - Street 1:1339 EAST ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-4228
Mailing Address - Country:US
Mailing Address - Phone:940-521-5500
Mailing Address - Fax:940-521-5511
Practice Address - Street 1:1339 EAST ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-4228
Practice Address - Country:US
Practice Address - Phone:940-521-5500
Practice Address - Fax:940-521-5511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9598207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154587301Medicaid
TX0044PYOtherBCBS
TXDG3958OtherRAILROAD PTAN (GROUP)
TX0044PYOtherBCBS