Provider Demographics
NPI:1366126336
Name:MAGEE, HALLE JO (PA-C)
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:JO
Last Name:MAGEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 OHIO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5256
Mailing Address - Country:US
Mailing Address - Phone:972-612-0430
Mailing Address - Fax:844-585-6193
Practice Address - Street 1:1705 OHIO DR STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5256
Practice Address - Country:US
Practice Address - Phone:972-612-0430
Practice Address - Fax:844-585-6193
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA17235363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant