MEDICARE: JOHN E HALBERDIER 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	207Q00000X	Family Medicine Physician	D9475	TX

General Provider Information

NPI Number	:	1336238815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN E HALBERDIER M.D.

Provider Business Mailing Address
First Line	:	827 MAGNOLIA BLVD
Second Line	:	SUITE 6
City	:	MAGNOLIA
State	:	TX
Zip	:	77355-8602
Country	:	US
Telephone Number	:	281-356-2900
Fax Number	:	281-356-5830

Provider Business Practice Location Address
First Line	:	827 MAGNOLIA BLVD
Second Line	:	SUITE 6
City	:	MAGNOLIA
State	:	TX
Zip	:	77355-8602
Country	:	US
Telephone Number	:	281-356-2900
Fax Number	:	281-356-5830

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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Directions to “ JOHN E HALBERDIER M.D.” Practice Location

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