Healthcare Provider Details

I. General information

NPI: 1659763316
Provider Name (Legal Business Name): BTDI JV, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 SW MILITARY DR
SAN ANTONIO TX
78221-1637
US

IV. Provider business mailing address

1431 PERRONE WAY
FRANKLIN TN
37069-4243
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CLETE MADDEN
Title or Position: PRESIDENT
Credential:
Phone: 615-661-9200