Provider Demographics
NPI:1871894220
Name:BALANDRAN MANAGEMENT & CONSULTING INC
Entity type:Organization
Organization Name:BALANDRAN MANAGEMENT & CONSULTING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ABRAM
Authorized Official - Last Name:BALANDRAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:832-770-9383
Mailing Address - Street 1:13711 WALLISVILLE RD. SUITE 2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049
Mailing Address - Country:US
Mailing Address - Phone:832-770-9383
Mailing Address - Fax:832-770-9387
Practice Address - Street 1:13711 WALLISVILLE RD. SUITE 2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049
Practice Address - Country:US
Practice Address - Phone:832-770-9383
Practice Address - Fax:832-770-9387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX279343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135906OtherPK
TX146283Medicaid