| NPI | 1174573430 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-05-10 |
| Last Updated | 2023-07-20 |
| Mailing Address | 816 W Cannon St Fort Worth, TX 76104-3146 United States 📍 View Map |
| Primary Practice Address | 815 Pennsylvania Ave Fort Worth, TX 76104-2224 United States Phone: (817) 321-0404 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | TX | 124683702 | - |
| MEDICAID | TX | 124683705 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 2085R0202X – Radiology, Diagnostic Radiology | TX | J6317 |
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About NPI 1174573430
Amy Brown Balis MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174573430. The primary specialty listed is Radiology, Diagnostic Radiology. The provider is located in Fort Worth, TX. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-05-10. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1174573430?
NPI 1174573430 belongs to Amy Brown Balis MD, a Radiology, Diagnostic Radiology in Fort Worth, TX. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1174573430 active?
The current status of NPI 1174573430 in the NPPES registry is Active. The record was last updated on 2023-07-20.
What specialty is NPI 1174573430?
NPI 1174573430 is classified under the taxonomy Radiology, Diagnostic Radiology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1174573430?
You can verify NPI 1174573430 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1174573430?
The primary practice address on file for NPI 1174573430 is 815 Pennsylvania Ave, Fort Worth, TX 76104-2224. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1174573430 issued?
NPI 1174573430 was first issued (enumerated) on 2006-05-10. The NPPES record was last updated on 2023-07-20.
Practice Location Map
Amy Brown Balis is located at 815 Pennsylvania Ave, Fort Worth, TX. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Amy Brown Balis. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1174573430. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Radiology, Diagnostic Radiology | J6317 | TX |