MEDICARE: CHRISTOPHER PAUL HALL ATC, LAT

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	2255A2300X	Athletic Trainer	AT0776	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AT0776	OTHER	TX	DEPARTMENT OF HEALTH- LAT
2	811995	OTHER	TX	NATA

General Provider Information

NPI Number	:	1982618054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER PAUL HALL ATC, LAT

Provider Business Mailing Address
First Line	:	4916 PRESTWICK DR
Second Line	:
City	:	COLLEYVILLE
State	:	TX
Zip	:	76034-4867
Country	:	US
Telephone Number	:	817-684-0409
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 STADIUM DRIVE- DANIEL MEYER COLISEUM
Second Line	:	TCU SPORTS MEDICINE
City	:	FT WORTH
State	:	TX
Zip	:	76129-0001
Country	:	US
Telephone Number	:	817-257-5399
Fax Number	:	817-257-6640

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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