Basic Information
| Provider Information | |||||||||
| NPI: | 1396002606 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2745 BEE CAVES RD | ||||||||
| Address2: | STE 101 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787465640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124012500 | ||||||||
| FaxNumber: | 5124012501 | ||||||||
| Practice Location | |||||||||
| Address1: | 355 LENNON LN STE 235 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945982544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259457005 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2012 | ||||||||
| LastUpdateDate: | 08/14/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YX0905X | Q9821 | TX | Y | Allopathic & Osteopathic Physicians | Otolaryngology | Otolaryngology/Facial Plastic Surgery |
No ID Information.