Provider Demographics
NPI:1780801415
Name:J.A. HALL, O.D., P.A.
Entity type:Organization
Organization Name:J.A. HALL, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-735-9000
Mailing Address - Street 1:2901 ALTA MERE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-4100
Mailing Address - Country:US
Mailing Address - Phone:817-735-9000
Mailing Address - Fax:817-735-9074
Practice Address - Street 1:2901 ALTA MERE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-4100
Practice Address - Country:US
Practice Address - Phone:817-735-9000
Practice Address - Fax:817-735-9074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6587TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty