Provider Demographics
NPI:1306560354
Name:BALCELLS, ISABELLA ELENA (DPT)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:ELENA
Last Name:BALCELLS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 BAGBY AVE APT 123
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76711-2309
Mailing Address - Country:US
Mailing Address - Phone:254-227-2431
Mailing Address - Fax:
Practice Address - Street 1:1500 S UNIVERSITY PARKS DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-1731
Practice Address - Country:US
Practice Address - Phone:254-227-2431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13574612081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine