MEDICARE: FRIEDA S HALE DDS PA

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	1223G0001X	General Practice Dentistry	11634	TX

General Provider Information

NPI Number	:	1639336290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIEDA S HALE DDS PA

Provider Business Mailing Address
First Line	:	3944 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3521
Country	:	US
Telephone Number	:	281-580-0770
Fax Number	:	281-580-6952

Provider Business Practice Location Address
First Line	:	3944 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3521
Country	:	US
Telephone Number	:	281-580-0770
Fax Number	:	281-580-6952

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. FRIEDA SUE HALE
Credential	:	DDS
Telephone Number	:	281-580-0770

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	05/21/2008

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