MEDICARE: BAY AREA PSYCHIATRY SERVICES PC

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	2084P0804X	Child & Adolescent Psychiatry Physician
2	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R3026	OTHER	TX	TEXAS MEDICAL BOARD

General Provider Information

NPI Number	:	1235898701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA PSYCHIATRY SERVICES PC

Provider Business Mailing Address
First Line	:	PO BOX 61160
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78466-1160
Country	:	US
Telephone Number	:	361-884-2904
Fax Number	:	361-884-2919

Provider Business Practice Location Address
First Line	:	6000 S STAPLES ST STE 406
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78413-2952
Country	:	US
Telephone Number	:	361-444-5255
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MANJUNATH BALARAM
Credential	:	MD
Telephone Number	:	361-444-5255

Provider Enumeration Date	:	12/13/2021
Last Update Date	:	12/03/2025

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