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Moritz Casper Wyler Von Ballmoos

Thoracic Surgery (Cardiothoracic Vascular Surgery)

Allopathic & Osteopathic Physicians

6550 Fannin St Ste 1401, Houston, TX 77030

PECOS Enrollment

This provider is enrolled in PECOS as MORITZ WYLER VON BALLMOOS.

Based on the most recent information from CMS, provider Moritz Casper Wyler Von Ballmoos is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1487970463
Provider Type
Individual
Full Name
Wyler Von Ballmoos, Moritz Casper
Title
Dr.
Credential
MD/PHD/MPH

Gender
Male
Sole Proprietor
No
Enumeration Date
4/15/2010
Last Updated
11/6/2018

Contact Information

Practice Location

6550 Fannin St Ste 1401, Houston, TX 77030

(713) 441-5200

Unlisted Fax

Mailing Location

6550 Fannin St Ste 1401, Houston, TX 77030-2738

(713) 441-5200

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208G00000X Primary	Description Thoracic Surgery (Cardiothoracic Vascular Surgery) Allopathic & Osteopathic Physicians	License R4499 Texas
Code 208600000X	Description Surgery Allopathic & Osteopathic Physicians	License 2016-01460 North Carolina
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 379135201	Description Medicaid	Issuer Unlisted Texas

Moritz Casper Wyler Von Ballmoos

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Reul, Ross M

Lee, Taek Yeon

Rice, David C.

He, Yuncen Atticus

Hofstetter, Wayne L.

Bobovnikov, Viachslav

Loor, Gabriel

Peng, Rick

Chen, Peter Chang

Sledz, Mariusz Andrzej