Rudolph Edward Balli, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA03012 Issued in TX

Practice address

7400 Merton Minter St
San Antonio, TX 78229-4404

Phone

(210) 617-5104

Fax

(210) 617-5349

NPI assigned

Sep 14, 2006

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

Physician Assistant

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1568567337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294404",
            "telephone_number": "210-617-5300",
            "fax_number": "210-617-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294404",
            "telephone_number": "210-617-5104",
            "fax_number": "210-617-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLI",
        "first_name": "RUDOLPH",
        "middle_name": "EDWARD",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA03012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Ballet
• Marcie Marjorie Balleza
• Candace Balli, LVN
• Matthew Eric Balli, LPC
• Renata Balli
• Jennifer Balliew
• Maxwell Ruff Balliew
• Rulyne K Ballinger, LCSW
• Lindsey Ballou
• Marichu Mabasa Balmes, MD

• Surgical Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.