Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 254824 | MA |
Y | 207VX0201X | Gynecologic Oncologist | P6409 | TX |
NPI | 1285864173 |
---|---|
Provider Name | Tracilyn R Hall |
First Address | Houston, TX 77030-2351 |
Second Address | Houston, TX 77054-4124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2009 |
Last Update Date | 13/11/2020 |