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Individual

DR. BALAMURUGAN PONNIAH SANKARAPANDIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1001 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2228
(817) 877-5858
(817) 335-4418
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 877-5858
(817) 335-4418

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N4721
TX
207RN0300X
Nephrology Physician
Primary
N4721
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205450401
TX
01
8U1257
BLUE CROSS
TX
Enumeration date
05/03/2007
Last updated
09/02/2022
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