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General NPI Number Information
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NPI Number | 1093866790
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Entity Type | Individual
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Provider Name | BALU SWAMY VISWANATHAN M.D
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 602 INDIANA AVE PEDIATRIC INTENSIVE CARE UNIT, UMC HEALTH SYSTEM
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City | LUBBOCK
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State | TX
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Zip | 79415-3364
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Country | US
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Telephone | 806-775-8828
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Fax |
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Provider Business Mailing Address
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Address Line | P.O BOX 54182
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City | LUBBOCK
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State | TX
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Zip | 79453
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Country | US
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Telephone | 806-792-9863
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Fax | 817-900-7666
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J2830
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | J2830
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License Number State | TX
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