Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NI0013X | Independent Medical Examiner | 6436 | TX |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 6436 | TX |
NPI | 1356734149 |
---|---|
Provider Name | Dr. Randall Halbert |
First Address | Spring, TX 77386-3798 |
Second Address | Spring, TX 77386-3798 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2015 |
Last Update Date | 18/03/2015 |