Provider Demographics
NPI:1891013652
Name:BALOGH, RYAN PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:PATRICK
Last Name:BALOGH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:P.O. BOX 961205
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-1205
Mailing Address - Country:US
Mailing Address - Phone:817-740-8400
Mailing Address - Fax:817-378-3699
Practice Address - Street 1:1650 W. COLLEGE STREET, BOX # 54
Practice Address - Street 2:BAYLOR SCOTT & WHITE GRAPEVINE, ATTN TRAUMA SERVICES
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3565
Practice Address - Country:US
Practice Address - Phone:817-388-3600
Practice Address - Fax:817-388-3610
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2015-11-12
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Provider Licenses
StateLicense IDTaxonomies
TXQ4897208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery