Edward a Balli, MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H5691 Issued in TX

Legal business name

EDWARD A BALLI, MD PA

Practice address

1375 E Walnut St
Suite 400
Seguin, TX 78155-5145

Phone

(830) 379-6823

Fax

(830) 379-3898

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Edward Allen Balli, M.D.

Title

President

Phone

(830) 379-6823

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1376569996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 E WALNUT ST",
            "address_2": "SUITE 400",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555145",
            "telephone_number": "830-379-6823",
            "fax_number": "830-379-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 E WALNUT ST",
            "address_2": "SUITE 400",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555145",
            "telephone_number": "830-379-6823",
            "fax_number": "830-379-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD A BALLI, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "BALLI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-379-6823",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H5691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.