Individual
BALA VISWANATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19260 STONE OAK PKWY, SUITE 102, SAN ANTONIO, TX 78258-3365
(210) 545-5455
(210) 545-0222
Mailing address
19260 STONE OAK PKWY, SUITE 102, SAN ANTONIO, TX 78258-3365
(210) 545-5455
(210) 545-0222
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G8766
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089817301
—
TX
Enumeration date
07/10/2006
Last updated
08/04/2008
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