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General NPI Number Information
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NPI Number | 1689549321
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Entity Type | Organization
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Legal Business Name | EVOLUTIONARY HEALTHCARE TEXAS PC
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 3400 E WALNUT ST
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City | PEARLAND
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State | TX
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Zip | 77581-4716
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Country | US
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Telephone | 321-387-9451
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Fax |
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Provider Business Mailing Address
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Address Line | 1931 19TH PL
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City | VERO BEACH
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State | FL
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Zip | 32960-3555
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Country | US
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Telephone | 321-387-9451
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HUSSIEN A BALLOUT
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Credential | MD
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Telephone | 321-387-9451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State |
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