Healthcare Provider Details

I. General information

NPI: 1083762843
Provider Name (Legal Business Name): DINAH HALL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 SOUTHWEST FWY
HOUSTON TX
77074-1407
US

IV. Provider business mailing address

13511 SHERWOOD ST
SUGAR LAND TX
77478-2739
US

V. Phone/Fax

Practice location:
  • Phone: 713-202-7654
  • Fax: 713-448-6986
Mailing address:
  • Phone: 281-313-1697
  • Fax: 713-448-6986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number25895
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: