Organization
BALCONES DERMATOLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE K FARADY MD (PRESIDENT)
(512) 459-4869
Entity
Organization
Contact information
Practice address
8240 N MOPAC EXPY, STE 350, AUSTIN, TX 78759-8840
(512) 459-4869
(512) 453-2795
Mailing address
8240 N MOPAC EXPY, STE 350, AUSTIN, TX 78759-8840
(512) 459-4869
(512) 453-2795
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00083K
BCBS
TX
05
—
079816701
—
TX
Enumeration date
07/19/2005
Last updated
07/21/2022
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