Individual
BHUVANA BALASEKARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1301 W. WALL ST., STE C, MIDLAND, TX 79701
(432) 570-4500
(432) 522-2115
Mailing address
1301 W. WALL ST., STE C, MIDLAND, TX 79701
(432) 570-4500
(432) 522-2115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L2794
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153987601
—
TX
01
—
470889174
FEDERAL TAX ID
TX
Enumeration date
11/14/2005
Last updated
10/15/2012
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