MEDICARE: DR. HURST MORELAND HALL III M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	P5076	TX
2	207RC0000X	Cardiovascular Disease Physician	P5076	TX
3	207RI0011X	Interventional Cardiology Physician	P5076	TX

General Provider Information

NPI Number	:	1205151834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HURST MORELAND HALL III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7708
Country	:	US
Telephone Number	:	214-645-8000
Fax Number	:	214-645-7269

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	01/18/2018

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