Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | J2047 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | J2047 | TX |
NPI | 1912961145 |
---|---|
Provider Name | Dr. Shelley A Hall |
First Address | Dallas, TX 75246-2057 |
Second Address | Dallas, TX 75246-2057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 07/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123575601 | (05) | TX |
123575604 | (05) | TX |
123575605 | (05) | TX |
85G131 | BCBS (01) | TX |
F70538 | (02) | TX |