Provider Demographics
NPI:1669693370
Name:BALTHAZAR, URSULA (MD)
Entity type:Individual
Prefix:
First Name:URSULA
Middle Name:
Last Name:BALTHAZAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 WEST LOOP S STE 395
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4110
Mailing Address - Country:US
Mailing Address - Phone:210-337-8453
Mailing Address - Fax:
Practice Address - Street 1:150 E SONTERRA BLVD STE 220
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4185
Practice Address - Country:US
Practice Address - Phone:210-337-8453
Practice Address - Fax:210-337-8452
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8575207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty