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General NPI Number Information
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NPI Number | 1467648956
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Entity Type | Organization
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Legal Business Name | BALCONES OBSTETRICS & GYNECOLOGY, PA
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 3705 MEDICAL PKWY SUITE 540
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City | AUSTIN
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State | TX
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Zip | 78705-1019
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Country | US
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Telephone | 512-452-8888
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Fax | 512-452-8889
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Provider Business Mailing Address
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Address Line | 3705 MEDICAL PKWY SUITE 540
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City | AUSTIN
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State | TX
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Zip | 78705-1019
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Country | US
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Telephone | 512-452-8888
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Fax | 512-452-8889
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Authorized Official
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Title or Position | PRESIDENT
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Name | NANCY E BINFORD
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Credential | MD
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Telephone | 512-452-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K0419
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License Number State | TX
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