Individual
CHARLES CHRIS BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2506 AUTUMN GARDEN CT, KINGWOOD, TX 77345-2233
(281) 360-6019
(281) 361-0762
Mailing address
2506 AUTUMN GARDEN CT, KINGWOOD, TX 77345-2233
(281) 360-6019
(281) 361-0762
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
15124
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
760538820
TAX ID
TX
Enumeration date
08/02/2006
Last updated
04/13/2009
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