Provider Demographics
NPI:1316635824
Name:BALAKRISHNAN, INDU
Entity type:Individual
Prefix:
First Name:INDU
Middle Name:
Last Name:BALAKRISHNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UTHEALTH JOHN S. DUNN BEHAVIORAL SCIENCES CAMPUS
Mailing Address - Street 2:2800 S. MACGREGOR WAY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021
Mailing Address - Country:US
Mailing Address - Phone:757-912-7021
Mailing Address - Fax:
Practice Address - Street 1:UTHEALTH JOHN S. DUNN BEHAVIORAL SCIENCES CAMPUS
Practice Address - Street 2:2800 S. MACGREGOR WAY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021
Practice Address - Country:US
Practice Address - Phone:757-912-7021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032089363LP0808X
VA0024187923363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health