Hallsville Medical Clinic PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

HALLSVILLE MEDICAL CLINIC PLLC

Practice address

209 W Main St Suite D
Hallsville, TX 75650

Phone

(903) 668-7462

Fax

(903) 668-7400

NPI assigned

Sep 23, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jean Rene Yates-Halbert, PA-CNPI 1831197342

Title

Partner

Phone

(903) 668-7462

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jean Rene Yates-Halbert, P.A.-C.

  • Medical Physician Assistant
  • Hallsville, TX
  • NPI 1831197342
  Medicare reassignment Authorized official
• Mary Katherine McGee, MD

  • Nephrology Physician
  • Longview, TX
  • NPI 1770562183
  Medicare reassignment NPD
• Samantha Jayne Roworth-Chaikin, DO

  • Pediatrics Physician
  • Longview, TX
  • NPI 1295712719
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1295406775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 873",
            "city": "HALLSVILLE",
            "state": "TX",
            "postal_code": "756500873",
            "telephone_number": "903-668-7462",
            "fax_number": "903-668-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W MAIN ST SUITE D",
            "city": "HALLSVILLE",
            "state": "TX",
            "postal_code": "75650",
            "telephone_number": "903-668-7462",
            "fax_number": "903-668-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALLSVILLE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "YATES-HALBERT",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "903-668-7462",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Eve Green, RN, BSN
• Brandon L Greer, DDS
• Harrison Griffin, LAT
• Hallsville Drug & Hardware LLC
• Hallsville Independent School District
• Hallsville Volunteer EMS
• Elizabeth Therese Hernandez, MS, RD, LD
• Lara Nicole Hood, M.S. CCC- SLP
• Jobie Brandice Howell, COTA
• Stephanie Lynne Hunt, NURSE PRACTITIONER

• General Practice Physician in Hallsville, TX
• Providers in Hallsville, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.