Active NPI
Mackenzie Balderaz
- Marriage & Family Therapist
- Deer Park, TX
National Provider Identifier
1447801311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 202321
- Practice address
- 1422 Hoover Dr
Deer Park, TX 77536-5157 - Phone
- (281) 733-0785
- NPI assigned
- Sep 23, 2019
- Last updated
- Sep 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 202321 | TX | Primary |
Addresses
Primary practice location
1422 Hoover Dr
Deer Park, TX 77536-5157
Mailing address
1422 Hoover Dr
Deer Park, TX 77536-5157
Phone (281) 733-0785
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202321 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1447801311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1422 HOOVER DR",
"city": "DEER PARK",
"state": "TX",
"postal_code": "775365157",
"telephone_number": "281-733-0785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1422 HOOVER DR",
"city": "DEER PARK",
"state": "TX",
"postal_code": "775365157",
"telephone_number": "281-733-0785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDERAZ",
"first_name": "MACKENZIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-23",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "202321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, TX
- Rhiannon Anderson
- Andlyco, LLC (All American Screening & Medical)
- Applied Behavior Partners, LLC
- Denise Evelyn Bach, ANP-C
- Elizabeth Delacy Baird, PAC
- Hasan Barlas
- Kelsey King Bass, M.A., LPC
- Francisca Eno Bassey, RN
- Bay Area Clinical Services PA (Clearwater Community Services)
- Bayshore Family Practitioners PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.