Provider Demographics
NPI:1851989974
Name:CARDIFF, HAL VICTOR JR
Entity Type:Individual
Prefix:
First Name:HAL
Middle Name:VICTOR
Last Name:CARDIFF
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12602 TOEPPERWEIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3204
Mailing Address - Country:US
Mailing Address - Phone:210-672-6509
Mailing Address - Fax:210-590-1759
Practice Address - Street 1:12602 TOEPPERWEIN RD STE 100
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3204
Practice Address - Country:US
Practice Address - Phone:210-672-6509
Practice Address - Fax:210-590-1759
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist