Individual
GARY MARVIN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12709 TOEPPERWEIN RD, STE 302, LIVE OAK, TX 78233-3258
(210) 653-9307
(210) 653-7014
Mailing address
8109 FREDERICKSBURG RD, PHYSICIAN PRACTICE SERVICES, SAN ANTONIO, TX 78229-3311
(210) 653-9307
(210) 653-7014
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F9523
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110509007
—
TX
01
—
110509008
CSHCN
TX
01
—
8DE710
BCBS
TX
01
—
P01124751
MEDICARE RAILROAD
—
Enumeration date
08/02/2006
Last updated
02/10/2022
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