Healthcare Provider Details

I. General information

NPI: 1629416292
Provider Name (Legal Business Name): BTDI JV LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 CHURCHILL DR STE 100
FLOWER MOUND TX
75022-2799
US

IV. Provider business mailing address

5214 MARYLAND WAY SUITE 200
BRENTWOOD TN
37027-5034
US

V. Phone/Fax

Practice location:
  • Phone: 972-724-0100
  • Fax:
Mailing address:
  • Phone: 615-661-9200
  • Fax: 615-661-9297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN C RICE JR.
Title or Position: CEO
Credential:
Phone: 615-661-9200