Provider Demographics
NPI:1063401313
Name:HALLIDAY, ALAN WOOD (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:WOOD
Last Name:HALLIDAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18227 OPENFOREST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3617
Mailing Address - Country:US
Mailing Address - Phone:210-916-2203
Mailing Address - Fax:210-916-3833
Practice Address - Street 1:BROOKE ARMY MEDICAL CENTER
Practice Address - Street 2:3851 ROGER BROOKE DRIVE
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-6200
Practice Address - Country:US
Practice Address - Phone:210-916-2203
Practice Address - Fax:210-916-3833
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2013-06-05
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Provider Licenses
StateLicense IDTaxonomies
TXJ57802084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG35998Medicare UPIN