Provider Demographics
NPI:1710697396
Name:BALBA, BRIAN ANTHONY (FNP-C)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:BALBA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23217 RED RIVER DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2031
Mailing Address - Country:US
Mailing Address - Phone:832-913-3262
Mailing Address - Fax:832-913-3282
Practice Address - Street 1:23217 RED RIVER DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2031
Practice Address - Country:US
Practice Address - Phone:832-913-3262
Practice Address - Fax:832-913-3282
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1093529363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily