Organization Active NPI

Balance Wound Care TX, LLC

  • Primary Care Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1861231300
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
BALANCE WOUND CARE TX, LLC
Doing business as
Balance Wound Care TX, LLC
Practice address
6320 Edgemere Blvd Ste 22
El Paso, TX 79925-3517
Phone
(915) 335-1977
Fax
(915) 591-2801
NPI assigned
May 23, 2024
Last updated
May 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Ana L MoradoNPI 1568645380
Title
Owner
Phone
(915) 335-1977

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NU Primary

Addresses

Primary practice location

6320 Edgemere Blvd Ste 22
El Paso, TX 79925-3517

Mailing address

9564 Verbena Dr
El Paso, TX 79924-6226
Phone (915) 335-1977

Other names 1

  • Balance Wound Care TX, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240822001636 TX Part B Supplier - Clinic/Group Practice 2860931805 Receives reassigned benefits from 1 practitioner
Practice locations: El Paso, TX
O20260318001686 NM Part B Supplier - Clinic/Group Practice 2860931805 Receives reassigned benefits from 1 practitioner
Practice locations: Chaparral, NM

National Provider Directory

National Provider Directory

Locations

309 Red Sun Dr
Ste 1E
Chaparral, NM 88081
Phone (915) 335-1977

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1861231300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9564 VERBENA DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799246226",
            "telephone_number": "915-335-1977",
            "fax_number": "915-591-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 EDGEMERE BLVD STE 22",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799253517",
            "telephone_number": "915-335-1977",
            "fax_number": "915-591-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE WOUND CARE TX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "MORADO",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-335-1977"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balance Wound Care TX, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.