Provider Demographics
NPI:1184097305
Name:HARMONIC TCM LLC
Entity type:Organization
Organization Name:HARMONIC TCM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WEN CHUN
Authorized Official - Middle Name:
Authorized Official - Last Name:TING
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:915-777-0019
Mailing Address - Street 1:3800 N MESA ST
Mailing Address - Street 2:SUITE A-2, PMB#182
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1538
Mailing Address - Country:US
Mailing Address - Phone:915-777-0019
Mailing Address - Fax:
Practice Address - Street 1:6006 N MESA ST
Practice Address - Street 2:SUITE 606
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4659
Practice Address - Country:US
Practice Address - Phone:915-777-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01668302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization