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Individual

MARVIN E. VAN HAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
729 W BEDFORD EULESS RD, SUITE 106, HURST, TX 76053-3939
(817) 282-1012
(817) 282-1015
Mailing address
729 W BEDFORD EULESS RD, SUITE 106, HURST, TX 76053-3939
(817) 282-1012
(817) 282-1015

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
H9171
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0031DF
BLUE CROSS BLUE SHIELD
TX
01
180192000
DEPARTMENT OF LABOR
TX
Enumeration date
06/24/2006
Last updated
07/16/2012
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