Provider Demographics
NPI:1962780825
Name:FRANK BALLESTEROS
Entity type:Organization
Organization Name:FRANK BALLESTEROS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLESTEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-947-3590
Mailing Address - Street 1:3505 CRESTDALE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-3703
Mailing Address - Country:US
Mailing Address - Phone:361-947-3590
Mailing Address - Fax:361-854-0026
Practice Address - Street 1:3921 SARATOGA BLVD
Practice Address - Street 2:STE 109
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-5819
Practice Address - Country:US
Practice Address - Phone:361-947-3590
Practice Address - Fax:361-854-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment