Individual
MR. CHARLES WILLIAM HALL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
415 N BROADWAY, CHINA, TX 77613
(409) 752-2301
(409) 752-5054
Mailing address
PO BOX 786, CHINA, TX 77613-0786
(409) 752-2301
(409) 752-5054
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01495
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141597803
—
TX
01
—
PA01495
LICENSE NUMBER
TX
Enumeration date
02/09/2007
Last updated
03/05/2012
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