Provider Demographics
NPI:1538970082
Name:HALL, CARLEY RENEE (LM)
Entity type:Individual
Prefix:
First Name:CARLEY
Middle Name:RENEE
Last Name:HALL
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-8537
Mailing Address - Country:US
Mailing Address - Phone:210-449-4829
Mailing Address - Fax:
Practice Address - Street 1:21708 HARDY OAK BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4860
Practice Address - Country:US
Practice Address - Phone:210-481-7549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99588176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife