Individual
DR. PHILLIP B BALLEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 EAST BRIN STREET, TERRELL, TX 75160-2938
(972) 524-6452
Mailing address
PO BOX 192709, DALLAS, TX 75219-8526
(214) 673-2674
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
H6023
TX
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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