Organization
HALLETT HEART PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT VICTOR HALLETT MD (OWNER)
(936) 631-3045
Entity
Organization
Contact information
Practice address
1113 ELLIS AVE, LUFKIN, TX 75904-3346
(936) 899-7184
(936) 899-7203
Mailing address
1113 ELLIS AVE, LUFKIN, TX 75904-3346
(936) 899-7184
(936) 899-7203
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0054LX
BC
TX
05
—
171970001
—
TX
01
—
DD0066
RAILROAD MEDICARE
TX
Enumeration date
02/13/2008
Last updated
04/17/2017
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