Provider Demographics
NPI:1710967906
Name:HALL, KRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
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 1:1740 ROSECRANS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-1928
Mailing Address - Country:US
Mailing Address - Phone:619-790-7800
Mailing Address - Fax:
Practice Address - Street 1:1325 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-3333
Practice Address - Country:US
Practice Address - Phone:361-729-0646
Practice Address - Fax:361-729-8854
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62482207P00000X
TXL8359207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG62695Medicare UPIN