Healthcare Provider Details
I. General information
NPI: 1093792293
Provider Name (Legal Business Name): BARRETT CRAIG HALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/28/2005
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13601 PRESTON RD STE 1000W
DALLAS TX
75240
US
IV. Provider business mailing address
PO BOX 840853
DALLAS TX
75284-0853
US
V. Phone/Fax
- Phone: 972-663-8523
- Fax: 972-663-8329
- Phone: 972-715-5000
- Fax: 972-233-3666
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | H6834 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: