Individual
DR. GRAHAM TREVOR HALL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7959 BROADWAY ST, SUITE 600, SAN ANTONIO, TX 78209-2667
(210) 826-7033
(210) 805-9523
Mailing address
7959 BROADWAY ST, SUITE 600, SAN ANTONIO, TX 78209-2667
(210) 826-7033
(210) 805-9523
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H4379
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F60M
BLUE CROSS BLUE SHIELD
TX
01
—
4295135
AETNA
TX
Enumeration date
07/18/2005
Last updated
07/08/2007
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