Provider Demographics
NPI:1144361874
Name:BALLINGER MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:BALLINGER MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-365-2125
Mailing Address - Street 1:PO BOX 463
Mailing Address - Street 2:
Mailing Address - City:BALLINGER
Mailing Address - State:TX
Mailing Address - Zip Code:76821-0463
Mailing Address - Country:US
Mailing Address - Phone:325-365-2125
Mailing Address - Fax:325-365-9995
Practice Address - Street 1:118 N 8TH ST
Practice Address - Street 2:
Practice Address - City:BALLINGER
Practice Address - State:TX
Practice Address - Zip Code:76821-5606
Practice Address - Country:US
Practice Address - Phone:325-365-2125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC21023Medicare UPIN
TX00R51UMedicare ID - Type Unspecified