Provider Demographics
NPI:1710026158
Name:RAO, BALCHANDER K (MD)
Entity Type:Individual
Prefix:
First Name:BALCHANDER
Middle Name:K
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:B
Other - Middle Name:K
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1631 NORTH LOOP WEST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008
Mailing Address - Country:US
Mailing Address - Phone:713-861-8884
Mailing Address - Fax:713-861-6312
Practice Address - Street 1:1631 NORTH LOOP WEST
Practice Address - Street 2:SUITE 450
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008
Practice Address - Country:US
Practice Address - Phone:713-861-8884
Practice Address - Fax:713-861-6312
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9350207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098793501Medicaid
TX098793501Medicaid
TX00FM61Medicare PIN