Healthcare Provider Details

I. General information

NPI: 1801593694
Provider Name (Legal Business Name): KENNETH BALINAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 AIRPORT FWY STE 230
BEDFORD TX
76021-6091
US

IV. Provider business mailing address

601 WREN CV
MCKINNEY TX
75072-5375
US

V. Phone/Fax

Practice location:
  • Phone: 817-354-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number90932
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: