Doctor Name: | DR. DIANE FAYE HALE |
NPI Number: | 1629205984 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 26057 |
Business Practice Address: | 3851 Roger Brooke Dr Mche-qd (creds) Fort Sam Houston, TX - 782344501 |
Business Phone Number: | 2109160439 |
Business Fax Number: | |
Mailing Address: | 3851 Roger Brooke Dr, Mche-qd (creds) FORT SAM HOUSTON |
State: | TX |
Postal Code: | 782344501 |
Phone Number: | 2109160439 |
Fax Number: | |
NPI Enumeration Date: | 06/15/2009 |
NPI Last Update Date: | 05/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 26057 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |