Provider Demographics
NPI:1295993392
Name:HALL, STACEY LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:LYNN
Last Name:HALL
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:6431 FANNIN MSB G550A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-799-5000
Mailing Address - Fax:713-799-5095
Practice Address - Street 1:1333 MOURSUND
Practice Address - Street 2:TIRR MEMORIAL HERMANN
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-799-5000
Practice Address - Fax:713-799-5095
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2022-10-04
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Provider Licenses
StateLicense IDTaxonomies
WI62960-21208100000X
TXR04072081P0010X
TXFTL 456822081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation