MEDICARE: DR. ALAN WOOD HALLIDAY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	J5780	TX
2	2084N0600X	Clinical Neurophysiology Physician	J5780	TX

General Provider Information

NPI Number	:	1063401313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN WOOD HALLIDAY M.D.

Provider Business Mailing Address
First Line	:	18227 OPENFOREST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-3617
Country	:	US
Telephone Number	:	210-916-2203
Fax Number	:	210-916-3833

Provider Business Practice Location Address
First Line	:	BROOKE ARMY MEDICAL CENTER
Second Line	:	3851 ROGER BROOKE DRIVE
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-6200
Country	:	US
Telephone Number	:	210-916-2203
Fax Number	:	210-916-3833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	06/05/2013

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Directions to “ DR. ALAN WOOD HALLIDAY M.D.” Practice Location

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