Provider Demographics
NPI:1700983988
Name:HALL-CRISMAN SPECIALITIES LLC
Entity type:Organization
Organization Name:HALL-CRISMAN SPECIALITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CRISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-842-1191
Mailing Address - Street 1:PO BOX 7270
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77726-7270
Mailing Address - Country:US
Mailing Address - Phone:409-842-1191
Mailing Address - Fax:
Practice Address - Street 1:1679 LINDBERGH DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-4132
Practice Address - Country:US
Practice Address - Phone:409-842-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X, 332BP3500X
TX0082279332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5457020001Medicare NSC