Basic Information
Provider Information
NPI: 1467772517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALINGER
FirstName: CHRISTOPHER
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 980790
Address2:  
City: HOUSTON
State: TX
PostalCode: 770980790
CountryCode: US
TelephoneNumber: 7133606857
FaxNumber: 7135831113
Practice Location
Address1: 204 W 19TH ST STE 200
Address2:  
City: HOUSTON
State: TX
PostalCode: 770084077
CountryCode: US
TelephoneNumber: 2813181122
FaxNumber: 7135831113
Other Information
ProviderEnumerationDate: 06/10/2010
LastUpdateDate: 09/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0122XS1762TXY Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery

No ID Information.


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