Provider Demographics
NPI:1679309199
Name:TYSON D HALE, MD PLLC
Entity type:Organization
Organization Name:TYSON D HALE, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-218-2237
Mailing Address - Street 1:PO BOX 293531
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-3531
Mailing Address - Country:US
Mailing Address - Phone:830-257-8484
Mailing Address - Fax:830-896-5211
Practice Address - Street 1:164 INSPIRATION LOOP
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-8409
Practice Address - Country:US
Practice Address - Phone:210-218-2237
Practice Address - Fax:830-896-5211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty