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Individual

ROMEO BALTAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
13601 PRESTON ROAD, #1000W, DALLAS, TX 75240
(972) 715-5007
(972) 715-5682
Mailing address
13601 PRESTON ROAD, #1000W, DALLAS, TX 75240
(972) 715-5007
(972) 715-5682

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G7781
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
098626702
TX
01
8AB552
BCBS
01
G7781
TSBME LIC
Enumeration date
06/30/2006
Last updated
11/13/2012
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