Provider Demographics
NPI:1811020928
Name:HALL VINCENT, ANITA H (OD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:H
Last Name:HALL VINCENT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8351 ANDERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-3625
Mailing Address - Country:US
Mailing Address - Phone:817-801-3202
Mailing Address - Fax:
Practice Address - Street 1:8351 ANDERSON BLVD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-3625
Practice Address - Country:US
Practice Address - Phone:817-801-3203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4478T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist