Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 11361 | TX |
NPI | 1376880732 |
---|---|
Provider Name | Dr. Jeffrey Wayne Hall |
First Address | Austin, TX 78749-6948 |
Second Address | Austin, TX 78749-6948 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2013 |
Last Update Date | 05/01/2013 |