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NPI Code Detail

MEDICARE: HALI TUBB RDH

MEDICARE:   HALI  TUBB  RDH
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
1124Q00000XDental Hygienist14699TX

General Provider Information

NPI Number : 1659563070
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALI TUBB RDH
Provider Business Mailing Address
First Line : 2033 W BEAUREGARD AVE
Second Line :
City : SAN ANGELO
State : TX
Zip : 76901-3883
Country : US
Telephone Number : 325-942-8577
Fax Number : 325-223-1480
Provider Business Practice Location Address
First Line : 2029 W BEAUREGARD AVE
Second Line :
City : SAN ANGELO
State : TX
Zip : 76901-3812
Country : US
Telephone Number : 325-657-8154
Fax Number : 325-486-9549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2007
Last Update Date : 08/10/2007

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Directions to “ HALI TUBB RDH” Practice Location

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