Mary Jo Balentine, HEARING AID DISPENSE

Key facts

NPI

1508071085

Entity type

Individual (NPI type 1)

Primary specialty

Hearing Instrument Specialist 237700000X

License

50349 (TX)

Practice address

1501 E Red River St
E2
Victoria, TX 77901-5522

Phone

(361) 578-4676

NPI assigned

May 10, 2007

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508071085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E.RED RIVER ST.",
            "address_2": "E2",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015531",
            "telephone_number": "361-578-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E RED RIVER ST",
            "address_2": "E2",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015522",
            "telephone_number": "361-578-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALENTINE",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "HEARING AID DISPENSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "TX",
            "license": "50349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

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• Reba Jane Baker
• Valerie Lyn Baker, O.D.
• Grace A Ballard
• Shannon Balli
• Angela Michelle Banduch, M.S., CCC-SLP
• Kelly C Banonis, NP
• Marianne Felice Fune Bantog, MD

All providers in Victoria, TX · Hearing Instrument Specialist in Texas