Provider Demographics
NPI:1801137179
Name:HALBERT, DAVID STAFFORD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STAFFORD
Last Name:HALBERT
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 1:3000 BLUFF CREST LN
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-4801
Mailing Address - Country:US
Mailing Address - Phone:325-668-6016
Mailing Address - Fax:
Practice Address - Street 1:3000 BLUFF CREST LN
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-4801
Practice Address - Country:US
Practice Address - Phone:325-668-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC7626208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB23263Medicare UPIN