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Organization
W BALLESTEROS LTD LLP
Active
Organization
W BALLESTEROS LTD LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WELLINGTON F BALLESTEROS MD (OWNER)
(432) 413-9658
Entity
Organization
Contact information
Practice address
5304 CASTLE PINE RD, MIDLAND, TX 79707-3204
(432) 697-1562
(432) 688-7735
Mailing address
PO BOX 9849, MIDLAND, TX 79708-9849
(432) 697-1562
(432) 688-7735
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H6770
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063RV
BLUE CROSS BLUE SHIELD
TX
05
—
130229108
—
TX
05
—
171584901
—
TX
Enumeration date
11/23/2007
Last updated
03/15/2010
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