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NPI Code Detail

MEDICARE: MS. B. JILL L BALAGUR-CONN LCSW

MEDICARE: MS. B. JILL L BALAGUR-CONN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1932125739
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. B. JILL L BALAGUR-CONN LCSW
Provider Business Mailing Address
First Line : 503 MANDARIN FLYWAY
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-4075
Country : US
Telephone Number : 512-528-1980
Fax Number : 512-528-9464
Provider Business Practice Location Address
First Line : 1490 E WHITESTONE BLVD
Second Line : SUITE 207
City : CEDAR PARK
State : TX
Zip : 78613-2274
Country : US
Telephone Number : 512-663-9950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 07/08/2007

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