Healthcare Provider Details

I. General information

NPI: 1316727704
Provider Name (Legal Business Name): JIFE LUXURY CAR SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4245 N CENTRAL EXPY STE 490
DALLAS TX
75205-4231
US

IV. Provider business mailing address

4245 N CENTRAL EXPY STE 490
DALLAS TX
75205-4231
US

V. Phone/Fax

Practice location:
  • Phone: 972-971-6394
  • Fax:
Mailing address:
  • Phone: 972-971-6394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: REGINALD JYLES
Title or Position: OWNER OPERATOR
Credential:
Phone: 972-971-6399