Susan Baltz
LBN: Grand Medical Clinic
Susan Baltz is an health care organization with primary practice located at 1416 S Hayden St , Amarillo TX 79102-1635. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is the primary health care specialty.
Grand Medical Clinic can be contacted via phone (806) 374-1919, or through Baltz, Susan A via phone (806) 374-1919.
Contact Information
Primary practice address
1416 S Hayden St
Amarillo TX 79102-1635
Phone: (806) 374-1919
Fax: (806) 379-9213
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | K2883 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 251159 | Texas |
Profile Details
| NPI number | 1265519623 |
|---|---|
| LBN Legal business name | Grand Medical Clinic |
| DBA Doing business as | Susan Baltz |
| Authorized official | Baltz, Susan A FAMILY NURSE PRACTIT |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Nov 20th, 2009 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265519623 | NPPES |
| Texas | MEDICAID | 092282501 | |
| Texas | Other | 8P0790 | |
| Texas | Other | 092280502 |
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