MEDICARE: DONALD A HALBARDIER P.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	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720187818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD A HALBARDIER P.C.

Provider Business Mailing Address
First Line	:	5050 FM 1960 WEST #126
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069
Country	:	US
Telephone Number	:	281-440-0814
Fax Number	:	281-440-6130

Provider Business Practice Location Address
First Line	:	5050 FM 1960 WEST #126
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069
Country	:	US
Telephone Number	:	281-440-0814
Fax Number	:	281-440-6130

Authorized Official
Title or Position	:	OWNER
Name	:	DONALD A HALBARDIER
Credential	:	DDS
Telephone Number	:	281-440-0814

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	06/20/2008

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