Provider Demographics
NPI:1902820491
Name:PREMIER HEART SPECIALISTS P A
Entity Type:Organization
Organization Name:PREMIER HEART SPECIALISTS P A
Other - Org Name:PALUR V BALAKRISHNAN MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PALUR
Authorized Official - Middle Name:V
Authorized Official - Last Name:BALAKRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-946-6081
Mailing Address - Street 1:4102 WOODLAWN
Mailing Address - Street 2:#110
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504
Mailing Address - Country:US
Mailing Address - Phone:713-946-6081
Mailing Address - Fax:713-946-6086
Practice Address - Street 1:4102 WOODLAWN
Practice Address - Street 2:#110
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504
Practice Address - Country:US
Practice Address - Phone:713-946-6081
Practice Address - Fax:713-946-6086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5827207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085778101Medicaid
TX0037DMOtherBLUE CROSS BLUE SHIELD
B21064Medicare UPIN
TX00U79MMedicare ID - Type Unspecified