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General NPI Number Information
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NPI Number | 1205384138
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Entity Type | Organization
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Legal Business Name | RJB CLINICA FAMILIAR, PLLC
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 315 N SHILOH RD STE 102
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City | GARLAND
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State | TX
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Zip | 75042-5783
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Country | US
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Telephone | 469-688-8523
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Fax | 469-458-9121
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Provider Business Mailing Address
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Address Line | 7417 SUGARBUSH DR
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City | GARLAND
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State | TX
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Zip | 75044-2633
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Country | US
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Telephone | 469-688-8523
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Fax | 469-458-9121
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACQUELINE BALARBAR
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Credential | FNP
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Telephone | 469-688-8523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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