Provider Demographics
NPI:1356734149
Name:HALBERT, RANDALL (DC)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:
Last Name:HALBERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 N OSSINEKE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3798
Mailing Address - Country:US
Mailing Address - Phone:936-615-6700
Mailing Address - Fax:
Practice Address - Street 1:5514 N OSSINEKE DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3798
Practice Address - Country:US
Practice Address - Phone:936-615-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6436111NI0013X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner