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General NPI Number Information
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NPI Number | 1669401105
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Entity Type | Individual
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Provider Name | MARY ELIZABETH HALL O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2630 N JOSEY LN STE 113
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City | CARROLLTON
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State | TX
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Zip | 75007-5545
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Country | US
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Telephone | 972-466-4400
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Fax | 972-466-4420
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Provider Business Mailing Address
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Address Line | 1112 BABBLING BROOK DR
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City | LEWISVILLE
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State | TX
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Zip | 75067-5502
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Country | US
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Telephone | 972-315-3134
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4088 T
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License Number State | TX
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