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General NPI Number Information
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NPI Number | 1467764167
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Entity Type | Individual
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Provider Name | AMIE REBECCA BALLARD M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 9250 PINECROFT DR
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City | SHENANDOAH
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State | TX
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Zip | 77380-3218
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Country | US
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Telephone | 713-897-2573
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Fax | 713-897-2522
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Provider Business Mailing Address
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Address Line | 9250 PINECROFT DR
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City | SHENANDOAH
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State | TX
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Zip | 77380-3218
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Country | US
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Telephone | 713-897-2573
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Fax | 713-897-2522
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | P5592
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License Number State | TX
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