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Individual

BRENDA C HALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
2002 OXFORD AVE, LUBBOCK, TX 79410
(806) 793-8869
(806) 793-0043
Mailing address
2002 OXFORD AVE, LUBBOCK, TX 79410
(806) 793-8869
(806) 793-0043

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03044
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00271685
RAILROAD MEDICARE
TX
Enumeration date
09/24/2006
Last updated
11/14/2007
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