MEDICARE: DR. KEVIN CHARLES HALL D.C.

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	111N00000X	Chiropractor	10094	TX

General Provider Information

NPI Number	:	1588826143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN CHARLES HALL D.C.

Provider Business Mailing Address
First Line	:	8900 SHOAL CREEK BLVD
Second Line	:	STE. A
City	:	AUSTIN
State	:	TX
Zip	:	78757-6810
Country	:	US
Telephone Number	:	512-458-4292
Fax Number	:	512-458-4293

Provider Business Practice Location Address
First Line	:	8900 SHOAL CREEK BLVD
Second Line	:	STE. A
City	:	AUSTIN
State	:	TX
Zip	:	78757-6810
Country	:	US
Telephone Number	:	512-458-4292
Fax Number	:	512-458-4293

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

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	06/25/2008

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