Healthcare Provider Details

I. General information

NPI: 1225559347
Provider Name (Legal Business Name): MANUEL ALBERTO BATLLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8471 GULF FWY
HOUSTON TX
77017-5001
US

IV. Provider business mailing address

8471 GULF FWY
HOUSTON TX
77017-5001
US

V. Phone/Fax

Practice location:
  • Phone: 832-709-2770
  • Fax: 832-924-0113
Mailing address:
  • Phone: 832-709-2770
  • Fax: 832-924-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberU1471
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: