Individual provider Active NPI

Diana Ayala-Balderas, LMSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1477950392
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
59815 Issued in TX
Practice address
303 Jackson Hill St
Houston, TX 77007-7407
Phone
(281) 200-9255
Fax
(281) 200-9777
NPI assigned
Nov 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 59815 TX Primary

Addresses

Primary practice location

303 Jackson Hill St
Houston, TX 77007-7407

Mailing address

5929 Queensloch Dr Apt 236
Houston, TX 77096-3849
Phone (832) 681-0558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59815TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Aug 8, 2023 Accepting new patients

Locations

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

1102 Bates Ave
#1450
Houston, TX 77030

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Interoperability endpoints

  • Direct secure messaging: dayalabalderas213719@prddirect.texaschildrens.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1477950392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 QUEENSLOCH DR APT 236",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770963849",
            "telephone_number": "832-681-0558",
            "fax_number": "281-200-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 JACKSON HILL ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770077407",
            "telephone_number": "281-200-9255",
            "fax_number": "281-200-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA-BALDERAS",
        "first_name": "DIANA",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-20",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.