Individual
DR. SALLY ANN HALLGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
311 UNIVERSITY DR, FORT WORTH, TX 76107-1924
(817) 877-4787
(817) 877-1654
Mailing address
311 UNIVERSITY DR, FORT WORTH, TX 76107-1924
(817) 877-4787
(817) 877-1654
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
E9484
TX
208VP0000X
Pain Medicine Physician
E9484
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0325318-01
—
TX
Enumeration date
10/11/2005
Last updated
02/22/2012
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