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General NPI Number Information
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NPI Number | 1245917087
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Entity Type | Organization
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Legal Business Name | BALANCED PATHWAYS
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Dates
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Enumeration Date | 07/03/2023
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 873 S STEMMONS FWY STE 100
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City | LEWISVILLE
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State | TX
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Zip | 75067-5351
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Country | US
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Telephone | 713-516-3849
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 JUSTIN RD STE 201
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City | LEWISVILLE
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State | TX
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Zip | 75077-2183
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Country | US
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Telephone | 713-516-3849
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOHN MUTHEGA
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Credential |
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Telephone | 171-351-6384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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