Provider Demographics
NPI:1659952026
Name:BELLAMORA HOLISTIC THERAPEUTIC SOLUTIONS LLC
Entity Type:Organization
Organization Name:BELLAMORA HOLISTIC THERAPEUTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:MAKIA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:713-260-2100
Mailing Address - Street 1:5900 BALCONES DR STE 8370
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4257
Mailing Address - Country:US
Mailing Address - Phone:713-260-2100
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 8370
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4257
Practice Address - Country:US
Practice Address - Phone:713-260-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-18
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty