Individual
MANUEL BALDERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-3509
(781) 744-8000
Mailing address
6031 WOOD PASS, SAN ANTONIO, TX 78249-1922
(210) 617-5130
(210) 617-5178
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
L0011
TX
2084P0800X
Psychiatry Physician
Primary
263953
MA
2084P0802X
Addiction Psychiatry Physician
L0011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1408884-02
TPI
—
Enumeration date
08/16/2006
Last updated
01/24/2023
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