Dehaven Diagnostics, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

DEHAVEN DIAGNOSTICS, LLC

Practice address

6116 Oakbend TRL
Suite 106
Fort Worth, TX 76132-3925

Phone

(817) 984-6210

Fax

(817) 984-6216

NPI assigned

Mar 12, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Judson Balch III, D.O.

Title

Physician

Phone

(817) 984-6210

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1124369459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 OAKBEND TRL",
            "address_2": "SUITE 106",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323925",
            "telephone_number": "817-984-6210",
            "fax_number": "817-984-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 OAKBEND TRL",
            "address_2": "SUITE 106",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323925",
            "telephone_number": "817-984-6210",
            "fax_number": "817-984-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEHAVEN DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "BALCH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JUDSON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "817-984-6210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Lauren Dees
• Madison Danielle Dees
• John David Deetjen, PA-C
• Elizabeth Degrand, OTD, OTR
• Charis Degrate
• Benjamin Michael Deheshi, MD
• Jonathan S. Deitch, M.D.
• Dejus LLC
• Jennifer D Del Angel, LCSW
• Katrina Camille Del Prado, RN

• Physical Medicine & Rehabilitation Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.