Provider Demographics
NPI:1184009573
Name:BALUCH, NADIR (MD)
Entity Type:Individual
Prefix:
First Name:NADIR
Middle Name:
Last Name:BALUCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 JACK WARNER PKWY UNIT B-109B
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1069
Mailing Address - Country:US
Mailing Address - Phone:312-593-7875
Mailing Address - Fax:
Practice Address - Street 1:110 E. SAVANNAH AVE
Practice Address - Street 2:BLDG B STE 203
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-686-7611
Practice Address - Fax:956-618-3164
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.38019207Q00000X
NDRL13644207Q00000X
TXS7386207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine