Healthcare Provider Details

I. General information

NPI: 1669465068
Provider Name (Legal Business Name): BAY AREA ENDOSCOPY CENTER, LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 FM 1959 RD STE B
HOUSTON TX
77034-5416
US

IV. Provider business mailing address

444 FM 1959 RD STE B
HOUSTON TX
77034-5416
US

V. Phone/Fax

Practice location:
  • Phone: 281-481-9400
  • Fax:
Mailing address:
  • Phone: 281-481-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number000328
License Number StateTX

VIII. Authorized Official

Name: DR. NATARAJAN S BALA
Title or Position: MEDICAL DIRECTOR
Credential: MD, FACP, FACG
Phone: 281-481-9400