Provider Demographics
NPI:1780168500
Name:KIRBY MEDICAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:KIRBY MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATARAJAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-892-2412
Mailing Address - Street 1:17043 EL CAMINO REAL STE 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2655
Mailing Address - Country:US
Mailing Address - Phone:281-954-0100
Mailing Address - Fax:281-954-0105
Practice Address - Street 1:15015 KIRBY DR STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-2587
Practice Address - Country:US
Practice Address - Phone:128-189-2241
Practice Address - Fax:832-448-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty