Provider Demographics
NPI:1598939399
Name:AMERICAN BALANCE CONTROL DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:AMERICAN BALANCE CONTROL DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-368-5833
Mailing Address - Street 1:9803 SPRING CYPRESS RD
Mailing Address - Street 2:SUITE 600-291
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6429
Mailing Address - Country:US
Mailing Address - Phone:832-368-5833
Mailing Address - Fax:
Practice Address - Street 1:9803 SPRING CYPRESS RD
Practice Address - Street 2:SUITE 600-291
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6429
Practice Address - Country:US
Practice Address - Phone:832-368-5833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1256208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00H16Y8Medicaid
TXP00H16Y8Medicaid