Provider Demographics
NPI:1205384138
Name:RJB CLINICA FAMILIAR, PLLC
Entity Type:Organization
Organization Name:RJB CLINICA FAMILIAR, PLLC
Other - Org Name:SU CLINICA FAMILIAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALARBAR
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:469-688-8523
Mailing Address - Street 1:7417 SUGARBUSH DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2633
Mailing Address - Country:US
Mailing Address - Phone:469-688-8523
Mailing Address - Fax:469-458-9121
Practice Address - Street 1:315 N SHILOH RD STE 102
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5783
Practice Address - Country:US
Practice Address - Phone:469-688-8523
Practice Address - Fax:469-458-9121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty