Provider Demographics
NPI:1881652865
Name:HALPENNY, WALTER H (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:H
Last Name:HALPENNY
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 1:6401 HARRIS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-6101
Mailing Address - Country:US
Mailing Address - Phone:817-346-2525
Mailing Address - Fax:817-294-1692
Practice Address - Street 1:6401 HARRIS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-6101
Practice Address - Country:US
Practice Address - Phone:817-346-2525
Practice Address - Fax:817-294-1692
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9355208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4462675OtherAETNA
TX10028670OtherAMERIGROUP
TX83218XOtherBCBS
TX4462675OtherAETNA