Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | T2877 | TX |
NPI | 1003223983 |
---|---|
Provider Name | Dr. Jason Robert Hall |
First Address | Fort Sam Houston, TX 78234-4504 |
Second Address | Texarkana, TX 75503-5228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2014 |
Last Update Date | 07/09/2021 |