Basic Information
Provider Information
NPI: 1437371432
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALAZS
FirstName: ANDREA
MiddleName: ERIKA
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: TWO GREENWAY PLAZA
Address2: SUITE 900
City: HOUSTON
State: TX
PostalCode: 770460297
CountryCode: US
TelephoneNumber: 7137981835
FaxNumber: 7137981144
Practice Location
Address1: 1504 TAUB LOOP
Address2: DEPT. OF PEDIATRICS
City: HOUSTON
State: TX
PostalCode: 770301608
CountryCode: US
TelephoneNumber: 7138732000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/02/2007
LastUpdateDate: 05/05/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XM1488TXN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0205XM1488TXY Allopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology

No ID Information.


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