Healthcare Provider Details

I. General information

NPI: 1821293499
Provider Name (Legal Business Name): HAILEY L HALL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/06/2024
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6620 MAIN ST SUITE H1300
HOUSTON TX
77030-2331
US

IV. Provider business mailing address

6620 MAIN ST SUITE H1300
HOUSTON TX
77030-2331
US

V. Phone/Fax

Practice location:
  • Phone: 713-797-1144
  • Fax: 832-825-7791
Mailing address:
  • Phone: 713-797-1144
  • Fax: 832-825-7791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberBP1-0026292
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberN5705
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberN5705
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: