Balis, Amy Brown
Balis, Amy Brown is an individual health care provider with primary practice located at 815 Pennsylvania Ave , Fort Worth TX 76104-2224. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Balis, Amy Brown can be contacted via phone (817) 321-0404.Contact Information
Primary practice address
815 Pennsylvania Ave
Fort Worth TX 76104-2224
Phone: (817) 321-0404
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | J6317 | Texas |
Profile Details
| NPI number | 1174573430 |
|---|---|
| LBN Legal business name | Balis, Amy Brown |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2006 |
| Last updated | Jul 20th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174573430 | NPPES |
| Texas | MEDICAID | 124683702 | |
| Texas | MEDICAID | 124683705 |
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