Provider Demographics
NPI:1285787085
Name:HALL, ROBIN ANNETTE (DO)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:ANNETTE
Last Name:HALL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E SOUTHLAKE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6375
Mailing Address - Country:US
Mailing Address - Phone:817-310-6050
Mailing Address - Fax:817-310-6051
Practice Address - Street 1:900 E SOUTHLAKE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6375
Practice Address - Country:US
Practice Address - Phone:817-310-6050
Practice Address - Fax:817-310-6051
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6268207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE45979Medicare UPIN
TXH6268OtherTEXAS MEDICAL LICENSE NO.
TXE45979Medicare UPIN
TXBH1943770OtherDEA NO.