Balla, Ildiko

Balla, Ildiko is an sole proprietor health care provider with primary practice located at 4200 S Hulen St Ste 658 , Fort Worth TX 76109-4987. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Balla, Ildiko can be contacted via phone (682) 597-3933.

Contact Information

Primary practice address
4200 S Hulen St Ste 658 Fort Worth TX 76109-4987
Phone: (682) 597-3933
Fax: (817) 274-8443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 16553 Texas
Behavioral Health & Social Service Providers / Counseling 103TC1900X 32879 Texas
Behavioral Health & Social Service Providers / Clinical 103TC0700X 32879 Texas

Profile Details

NPI number 1437368446
LBN Legal business name Balla, Ildiko
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 22nd, 2007
Last updated Mar 7th, 2012 - about 12 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437368446 NPPES
Texas MEDICAID 028537102

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