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Individual

DR. BALU SWAMY VISWANATHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
602 INDIANA AVE, PEDIATRIC INTENSIVE CARE UNIT, UMC HEALTH SYSTEM, LUBBOCK, TX 79415-3364
(806) 775-8828
Mailing address
P.O BOX 54182, LUBBOCK, TX 79453
(806) 792-9863
(817) 900-7666

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J2830
TX
2080P0203X
Pediatric Critical Care Medicine Physician
J2830
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00J07N
BLUE CROSS
TX
Enumeration date
01/16/2007
Last updated
09/11/2025
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