Individual
LILLY BALSAMO GANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
2106 RABB GLEN ST, AUSTIN, TX 78704-3946
(512) 580-9204
Mailing address
7800 SONG SPARROW DR, AUSTIN, TX 78744-4711
(214) 236-5970
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1207033
TX
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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