Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | K1974 | TX |
Y | 207PE0004X | Emergency Medical Services | K1974 | TX |
NPI | 1194783787 |
---|---|
Provider Name | James Balarbar |
First Address | Austin, TX 78732-2138 |
Second Address | Round Rock, TX 78681-4004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 11/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118700704 | (05) | TX |
G77894 | (02) | TX |