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General NPI Number Information
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NPI Number | 1366167595
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Entity Type | Individual
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Provider Name | NATHAN HALL DPT, PT
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Gender | Male
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 3801 S LAMAR BLVD
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City | AUSTIN
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State | TX
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Zip | 78704-8171
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Country | US
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Telephone | 505-410-2716
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Fax |
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Provider Business Mailing Address
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Address Line | 1807 WALNUT AVE
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City | AUSTIN
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State | TX
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Zip | 78702-1537
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Country | US
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Telephone | 505-410-2716
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1368692
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License Number State | TX
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