=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568568079
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DONALD A HALBARDIER DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5050 FM 1960 RD W STE 126
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77069-4525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-440-0814
-----------------------------------------------------
Fax | 281-440-6130
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5050 FM 1960 RD W STE 126
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77069-4525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-440-0814
-----------------------------------------------------
Fax | 281-440-6130
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 9788
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------