# SALLY A HALLGREN, D.O., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336425289
- **Authorized official:** STEPHANIE JANE WILLIAMS (OFFICE MANAGER)
- **Authorized official phone:** (817) 877-4787

## Contact information

- **Practice address:** 311 UNIVERSITY DR, FORT WORTH, TX 76107-1924
- **Practice address phone:** (817) 877-4787
- **Practice address fax:** (817) 877-1654
- **Mailing address:** 311 UNIVERSITY DR, FORT WORTH, TX 76107-1924
- **Mailing address phone:** (817) 877-4787
- **Mailing address fax:** (817) 877-1654

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | E9484 | TX | Yes |

## Other

- **Enumeration date:** 10/24/2011
- **Last updated:** 11/21/2011