Provider Demographics
NPI:1821278532
Name:HALL, VONDALYN S (RMT)
Entity Type:Individual
Prefix:MS
First Name:VONDALYN
Middle Name:S
Last Name:HALL
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2616 S LOOP W
Mailing Address - Street 2:SUITE #120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2662
Mailing Address - Country:US
Mailing Address - Phone:832-731-8147
Mailing Address - Fax:832-778-7771
Practice Address - Street 1:2616 S LOOP W
Practice Address - Street 2:SUITE #120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2662
Practice Address - Country:US
Practice Address - Phone:832-731-8147
Practice Address - Fax:832-778-7771
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT028550174400000X, 225700000X, 173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist
No173C00000XOther Service ProvidersReflexologist