=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790655439
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT HALL
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2025
-----------------------------------------------------
Last Update Date | 11/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 363 N SAM HOUSTON PKWY E STE E750
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77060-2404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-244-5770
-----------------------------------------------------
Fax | 713-244-5755
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31210 ALBANY BROOK LN
-----------------------------------------------------
City | HOCKLEY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77447-2090
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-766-8555
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------