Provider Demographics
NPI:1073781746
Name:KENYA J BALLARD MSN APRN PMHMP PLLC
Entity Type:Organization
Organization Name:KENYA J BALLARD MSN APRN PMHMP PLLC
Other - Org Name:NORTH EAST TEXAS PSYCHIATRIC ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMHMP
Authorized Official - Phone:214-528-8606
Mailing Address - Street 1:9554 COUNTY ROAD 2440
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-3082
Mailing Address - Country:US
Mailing Address - Phone:214-552-8606
Mailing Address - Fax:
Practice Address - Street 1:9554 COUNTY ROAD 2440
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-3082
Practice Address - Country:US
Practice Address - Phone:214-552-8606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty