Ballem Harmony LLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Bryan, TX
NPI 1124844469 · NPPES record last updated Feb 18, 2025
Key facts
- NPI
- 1124844469
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- BALLEM HARMONY LLC
- Practice address
- 4500 Carter Creek Pkwy Ste 101
Bryan, TX 77802-4464 - Phone
- (210) 367-1530
- NPI assigned
- Dec 3, 2024
- Organization subpart
- No
Authorized official
- Name
- Clarisa Che Minang
- Title
- Owner
- Phone
- (210) 367-1530
Practitioners 8
-
Ayuk Grace Ayuk, PMHNP-BC
-
Julia Benavides, NP
-
Delphine Fru, APRN, PMHNP-BC
-
Queen Idowu, PMHNP
-
Linda Sevidzem Mbang, MSN, APRN, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241219004187 | TX | Part B Supplier - Clinic/Group Practice | 9638606213 |
Receives reassigned benefits from 7 practitioners Practice locations: Bryan, TX |
National Provider Directory
Locations
4500 Carter Creek Pkwy
Ste 101
Bryan, TX 77802
Phone (210) 367-1530
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
4500 Carter Creek Pkwy Ste 101
Bryan, TX 77802-4464
Mailing address
4500 Carter Creek Pkwy Ste 101
Bryan, TX 77802-4464
Phone (210) 367-1530
Other providers in Bryan, TX
- David Norman Bailey
- Baker O & P Enterprises, Inc.
- Taunyana Taniese Baker-Sanchez
- Ronny D Baker
- Katina Yvette Baldwin
- Ballew Therapy Services, LLC
- Lindsay Ballew
- Rashanda R Banks
- Nathan Charles Barker
- Troy Edward Barnes
All providers in Bryan, TX · Psychiatric/Mental Health Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.