Provider Demographics
NPI:1336238815
Name:HALBERDIER, JOHN E (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:HALBERDIER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:827 MAGNOLIA BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-8602
Mailing Address - Country:US
Mailing Address - Phone:281-356-2900
Mailing Address - Fax:281-356-5830
Practice Address - Street 1:827 MAGNOLIA BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-8602
Practice Address - Country:US
Practice Address - Phone:281-356-2900
Practice Address - Fax:281-356-5830
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD9475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760538674OtherGROUP TAX ID NUMBER