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General NPI Number Information
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NPI Number | 1366954588
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Entity Type | Organization
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Legal Business Name | DR KANISHA HALL PLLC
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 400 S MAIN ST
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City | SAINT MARTINVILLE
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State | LA
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Zip | 70582-4544
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Country | US
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Telephone | 202-709-9822
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Fax |
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Provider Business Mailing Address
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Address Line | 5315B CYPRESS CREEK PKWY # 193
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City | HOUSTON
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State | TX
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Zip | 77069-4403
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Country | US
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Telephone | 202-709-9822
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KANISHA HALL
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Credential | MD
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Telephone | 202-709-9822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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