Provider Demographics
NPI:1053421784
Name:HALL, JAMES (PT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 POWELL DR
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-1936
Mailing Address - Country:US
Mailing Address - Phone:254-644-1010
Mailing Address - Fax:
Practice Address - Street 1:1616 AZALEA DR
Practice Address - Street 2:STE 106
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2774
Practice Address - Country:US
Practice Address - Phone:254-771-9003
Practice Address - Fax:254-771-9006
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1103117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1103117OtherLICENSE#