MEDICARE: HAILEE SETTLE

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	390200000X	Student in an Organized Health Care Education/Training Program	165503303515	TX

General Provider Information

NPI Number	:	1427589126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAILEE SETTLE

Provider Business Mailing Address
First Line	:	2624 PROSPECT HEIGHTS DR
Second Line	:	APT. 14101
City	:	FORT WORTH
State	:	TX
Zip	:	76110-7427
Country	:	US
Telephone Number	:	682-564-6290
Fax Number	:

Provider Business Practice Location Address
First Line	:	2624 PROSPECT HEIGHTS DR
Second Line	:	APT. 14101
City	:	FORT WORTH
State	:	TX
Zip	:	76110-7427
Country	:	US
Telephone Number	:	682-564-6290
Fax Number	:

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

Provider Enumeration Date	:	03/23/2017
Last Update Date	:	03/23/2017

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Directions to “ HAILEE SETTLE ” Practice Location

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