Provider Demographics
NPI:1710274147
Name:VAN HAL, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:VAN HAL
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 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-3203
Mailing Address - Country:US
Mailing Address - Phone:214-546-0624
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5303 HARRY HINES BLVD
Practice Address - Street 2:6TH FLOOR
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8810
Practice Address - Country:US
Practice Address - Phone:214-645-2225
Practice Address - Fax:214-645-8451
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9068207XS0117X
PA198983207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery