Individual
MR. DUSTIN DURAND HALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, AG-ACNP
Contact information
Practice address
6800 W IH 10 STE 350, SAN ANTONIO, TX 78201-2044
(210) 692-1414
Mailing address
10015 AMBER BREEZE, SAN ANTONIO, TX 78245-2932
(806) 543-0868
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
850505
TX
363L00000X
Nurse Practitioner
Primary
1153885
TX
363LA2100X
Acute Care Nurse Practitioner
1153885
TX
Other
Enumeration date
05/08/2024
Last updated
05/31/2024
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