Individual
DR. EMMET HEZEKIAH BALCH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1845 PRECINCT LINE RD STE 209, HURST, TX 76054-3109
(817) 336-4638
(817) 336-1331
Mailing address
1845 PRECINCT LINE RD STE 209, HURST, TX 76054-3109
(817) 336-4638
(817) 336-1331
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
F9163
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124445102
—
TX
01
—
80R342
MEDICARE - PTAN
TX
Enumeration date
08/12/2005
Last updated
08/18/2016
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