Healthcare Provider Details

I. General information

NPI: 1962486803
Provider Name (Legal Business Name): BBJI, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 LAUREL ST
BEAUMONT TX
77707-2216
US

IV. Provider business mailing address

3650 LAUREL ST
BEAUMONT TX
77707-2216
US

V. Phone/Fax

Practice location:
  • Phone: 409-838-0346
  • Fax:
Mailing address:
  • Phone: 409-838-0346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number008265
License Number StateTX

VIII. Authorized Official

Name: MR. DUANE NATHAN HILL
Title or Position: ADMINISTRATOR & GENERAL COUNSEL
Credential:
Phone: 409-838-0346