Provider Demographics
NPI:1336323492
Name:AL-BALAS, HASSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:
Last Name:AL-BALAS
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 1:6807 STAFFORDSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-857-4380
Mailing Address - Fax:832-838-1461
Practice Address - Street 1:6807 STAFFORDSHIRE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4107
Practice Address - Country:US
Practice Address - Phone:713-857-4380
Practice Address - Fax:832-838-1461
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM84762085R0202X
FLME987442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB113802Medicare PIN