Active NPI
Sally Ann Hallgren, D.O.
- Pain Medicine (Anesthesiology) Physician
- Fort Worth, TX
National Provider Identifier
1114915402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- E9484
- Practice address
- 311 University Dr
Fort Worth, TX 76107-1924 - Phone
- (817) 877-4787
- Fax
- (817) 877-1654
- NPI assigned
- Oct 11, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | E9484 | TX | Primary |
| Pain Medicine Physician | 208VP0000X | E9484 | TX |
Addresses
Primary practice location
311 University Dr
Fort Worth, TX 76107-1924
Mailing address
311 University Dr
Fort Worth, TX 76107-1924
Phone (817) 877-4787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0325318-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E9484 | TX | MD | Pain Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1114915402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 UNIVERSITY DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761071924",
"telephone_number": "817-877-4787",
"fax_number": "817-877-1654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 UNIVERSITY DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761071924",
"telephone_number": "817-877-4787",
"fax_number": "817-877-1654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLGREN",
"first_name": "SALLY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-11",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "TX",
"license": "E9484",
"primary": true
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "TX",
"license": "E9484",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0325318-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
- Yaneya Armas Hall, PHARMD
- Hall'S Long Term Care Pharmacy, Inc.
- Hall'S Pharmacy
- Jennifer Marlene Hallcroft, LPC
- Heather Hallford-Alexander, LPC
- Hallmark Family Dental PA
- Joseph Paul Hallock, CPNP
- Halls IV & Institutional Pharmacy Dba Xpress Compounding Pharmacy
- Walter H. Halpenny, M.D.
- Haltom Operations, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.