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General NPI Number Information
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NPI Number | 1619546504
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Entity Type | Individual
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Provider Name | ALBATINA HALLENBECK LPN
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Gender | Female
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 1111 W MOCKINGBIRD LN STE 1400
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City | DALLAS
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State | TX
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Zip | 75247-5014
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Country | US
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Telephone | 469-619-0509
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Fax |
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Provider Business Mailing Address
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Address Line | 620 W WESTCHESTER PKWY APT 17102
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-3265
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Country | US
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Telephone | 469-987-0074
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 145881
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License Number State | TX
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