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NPI Code Detail

MEDICARE: ALYSIA RAE HALL

MEDICARE: ALYSIA RAE HALL
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
1363LA2100XAcute Care Nurse Practitioner1086965TX

General Provider Information

NPI Number : 1588399059
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSIA RAE HALL
Provider Business Mailing Address
First Line : 2732 FERDINAND
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-5519
Country : US
Telephone Number : 817-706-0737
Fax Number :
Provider Business Practice Location Address
First Line : 5200 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-7709
Country : US
Telephone Number : 214-590-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2022
Last Update Date : 01/27/2026

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Directions to “ ALYSIA RAE HALL ” Practice Location

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