MEDICARE: BALLEW & ASSOCIATES PODIATRY, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CG1197	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00166N	OTHER	TX	BC/BS GROUP ID

General Provider Information

NPI Number	:	1154396760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALLEW & ASSOCIATES PODIATRY, P.A.

Provider Business Mailing Address
First Line	:	201 COLONNADE PKWY
Second Line	:	SUITE 100
City	:	WACO
State	:	TX
Zip	:	76712-6174
Country	:	US
Telephone Number	:	254-779-6995
Fax Number	:	254-776-5577

Provider Business Practice Location Address
First Line	:	201 COLONNADE PKWY
Second Line	:	SUITE 100
City	:	WACO
State	:	TX
Zip	:	76712-6174
Country	:	US
Telephone Number	:	254-779-6995
Fax Number	:	254-776-5577

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KARINA LOYA
Credential	:	D.P.M.
Telephone Number	:	254-776-6995

Provider Enumeration Date	:	02/18/2006
Last Update Date	:	12/01/2014

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Directions to “BALLEW & ASSOCIATES PODIATRY, P.A. ” Practice Location

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