MEDICARE: DR. LAURI BALLARD 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
1	207R00000X	Internal Medicine Physician	L3917	TX

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	8050B6	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1689624488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURI BALLARD M.D.

Provider Business Mailing Address
First Line	:	7640 NE LOOP 820 STE 100
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8340
Country	:	US
Telephone Number	:	817-284-8222
Fax Number	:	817-284-0287

Provider Business Practice Location Address
First Line	:	7640 NE LOOP 820 STE 100
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8340
Country	:	US
Telephone Number	:	817-284-8222
Fax Number	:	817-284-0287

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	11/05/2025

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