Jace Balzen, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

P5508 Issued in TX

Practice address

11398 Bandera Rd Ste 201
San Antonio, TX 78250

Phone

(210) 281-8669

Fax

(210) 314-5044

NPI assigned

May 28, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1376701177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 SAN PEDRO AVE STE 412",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322009",
            "telephone_number": "210-281-8669",
            "fax_number": "210-314-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11398 BANDERA RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78250",
            "telephone_number": "210-281-8669",
            "fax_number": "210-314-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALZEN",
        "first_name": "JACE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P5508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Balter
• Ursula Balthazar, M.D.
• Christopher Baltimore
• Simon Balvin, D.P.M.
• Elizabeth Svyatoslavna Balyakina, MS, MPH, DO
• Niva Bamback, DO
• Parker Bamback, MD
• Pavela G. Bambekova, MD
• Husna Bambo, M.D
• Joseph Bambola

• Pediatrics Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.