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General NPI Number Information
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NPI Number | 1265523948
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Entity Type | Organization
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Legal Business Name | BALANCE DIAGNOSTIC MC, LLP
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 4141 SOUTHWEST FWY SUITE 110
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City | HOUSTON
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State | TX
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Zip | 77027-7313
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Country | US
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Telephone | 713-223-1800
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Fax | 713-669-0088
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Provider Business Mailing Address
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Address Line | 4141 SOUTHWEST FWY SUITE 110
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City | HOUSTON
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State | TX
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Zip | 77027-7313
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Country | US
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Telephone | 713-223-1800
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Fax | 713-669-0088
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARY LOUISE WESSELS
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Credential |
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Telephone | 713-223-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | NOT APPLICABLE
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License Number State | TX
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