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General NPI Number Information
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NPI Number | 1982742367
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Entity Type | Organization
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Legal Business Name | JOHNNY L. HALEY
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2900 S. LOOP 256
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City | PALESTINE
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State | TX
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Zip | 75801
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Country | US
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Telephone | 903-731-1143
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 54038
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City | NEW ORLEANS
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State | LA
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Zip | 70154-4000
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Country | US
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Telephone | 903-731-1143
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Fax |
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Authorized Official
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Title or Position | HR DIRECTOR
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Name | BIRGIT JAMES
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Credential |
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Telephone | 512-238-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | G4850
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License Number State | TX
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