Healthcare Provider Details

I. General information

NPI: 1982959813
Provider Name (Legal Business Name): JPR DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 S LOOP W SUITE 522 RM B
HOUSTON TX
77054-2654
US

IV. Provider business mailing address

2626 S LOOP W SUITE 522 RM B
HOUSTON TX
77054-2654
US

V. Phone/Fax

Practice location:
  • Phone: 713-661-2100
  • Fax:
Mailing address:
  • Phone: 713-661-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARLETTE MORRIS
Title or Position: CREDENTIALING
Credential:
Phone: 713-661-2100