Michael D Ballard, | |
4215 Joe Ramsey Blvd E, Greenville, TX 75401-7852 | |
(903) 408-5000 | |
Not Available |
Full Name | Michael D Ballard |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 4215 Joe Ramsey Blvd E, Greenville, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467154500 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 923608 (Texas) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 1134895 (Texas) | Primary |
Entity Name | Northstar Anesthesia Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912978610 PECOS PAC ID: 7315907128 Enrollment ID: O20041015000685 |
Entity Name | Texas Regional Anesthesia Medical Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457702201 PECOS PAC ID: 8325328628 Enrollment ID: O20161202000581 |
Mailing Address | Practice Location Address |
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Michael D Ballard, 372 County Road 1100, Cooper, TX 75432-6804 Ph: (903) 450-6702 | Michael D Ballard, 4215 Joe Ramsey Blvd E, Greenville, TX 75401-7852 Ph: (903) 408-5000 |
Brynn Marie Steward, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4215 Joe Ramsey Blvd E, Greenville, TX 75401 Phone: 903-408-5000 | |
Mr. Joel Schop, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4215 Joe Ramsey Blvd E, Greenville, TX 75401 Phone: 903-408-1218 |