MEDICARE: INGABIRE GRACE BALINDA MD

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	208M00000X	Hospitalist Physician	282332	MA
2	207RC0000X	Cardiovascular Disease Physician	V2696	TX
3	207RC0000X	Cardiovascular Disease Physician	38842	NH
4	207R00000X	Internal Medicine Physician	272083	MA

General Provider Information

NPI Number	:	1467982611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INGABIRE GRACE BALINDA MD

Provider Business Mailing Address
First Line	:	55 FRUIT ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02114-2621
Country	:	US
Telephone Number	:	617-643-0596
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 W TERRELL AVE STE 500
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2810
Country	:	US
Telephone Number	:	817-252-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2017
Last Update Date	:	12/01/2025

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