Provider Demographics
NPI:1396989968
Name:HALLMAN, LUIS ALBERTO (IDMT)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ALBERTO
Last Name:HALLMAN
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3516 ADENMOR CT
Mailing Address - Street 2:UNIT B
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-2820
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3516 ADENMOR CT
Practice Address - Street 2:UNIT B
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-2820
Practice Address - Country:US
Practice Address - Phone:575-218-4925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians