Individual provider Active NPI

Antonio Ricardo Balboa, PHARMD

  • Pharmacist
  • Hidalgo, TX
National Provider Identifier
1295335347
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
54414 Issued in TX
Practice address
3000 N Jackson Rd
Hidalgo, TX 78557-3882
Phone
(956) 904-4829
NPI assigned
Oct 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 54414 TX Primary

Addresses

Primary practice location

3000 N Jackson Rd
Hidalgo, TX 78557-3882

Mailing address

950 S Mile 2 W
Mercedes, TX 78570-7419
Phone (956) 314-3839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
54414TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1295335347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S MILE 2 W",
            "city": "MERCEDES",
            "state": "TX",
            "postal_code": "785707419",
            "telephone_number": "956-314-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N JACKSON RD",
            "city": "HIDALGO",
            "state": "TX",
            "postal_code": "785573882",
            "telephone_number": "956-904-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBOA",
        "first_name": "ANTONIO",
        "middle_name": "RICARDO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "54414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hidalgo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.