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Organization
WF BALLESTEROS MD
Active
Organization
WF BALLESTEROS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WELLINGTON F BALLESTEROS MD (OWNER)
(432) 697-1562
Entity
Organization
Contact information
Practice address
3901 FAIRWOOD CT, MIDLAND, TX 79707-1428
(432) 697-1562
(432) 699-3801
Mailing address
3901 FAIRWOOD CT, MIDLAND, TX 79707-1428
(432) 697-1562
(432) 699-3801
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H6770
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00B18X
BLUE CROSS BLUE SHEILD
TX
05
—
130229103
—
TX
Enumeration date
05/07/2008
Last updated
05/07/2008
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