Individual
RESTITUTO E BALUYOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 GATES BOULEVARD, PORT ARTHUR, TX 77642-3601
(409) 985-7431
Mailing address
PO BOX 1888, GREENVILLE, TX 75403
(800) 945-2455
(903) 453-2541
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E6990
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136980301
—
TX
Enumeration date
04/18/2006
Last updated
07/27/2011
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