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NPI Code Detail

MEDICARE: SUBRAMANIAM BALACHANDRAN M.D.

MEDICARE: SUBRAMANIAM BALACHANDRAN M.D.
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
1208600000XSurgery PhysicianG0656TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
415AROTHERTXBLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number : 1225034010
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUBRAMANIAM BALACHANDRAN M.D.
Provider Business Mailing Address
First Line : PO BOX 797
Second Line :
City : LANCASTER
State : TX
Zip : 75146-0797
Country : US
Telephone Number : 254-694-5092
Fax Number : 254-694-7039
Provider Business Practice Location Address
First Line : 1007 S WILLIAM ST
Second Line :
City : ATLANTA
State : TX
Zip : 75551-3245
Country : US
Telephone Number : 903-799-3326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2005
Last Update Date : 05/21/2010

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