Provider Demographics
NPI:1124844469
Name:BALLEM HARMONY LLC
Entity type:Organization
Organization Name:BALLEM HARMONY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARISA
Authorized Official - Middle Name:CHE
Authorized Official - Last Name:MINANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-367-1530
Mailing Address - Street 1:4500 CARTER CREEK PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-4464
Mailing Address - Country:US
Mailing Address - Phone:210-367-1530
Mailing Address - Fax:
Practice Address - Street 1:4500 CARTER CREEK PKWY STE 101
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-4464
Practice Address - Country:US
Practice Address - Phone:210-367-1530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty