Healthcare Provider Details

I. General information

NPI: 1932928652
Provider Name (Legal Business Name): BTDI JV, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 S 10TH ST STE 210
WACO TX
76706-1388
US

IV. Provider business mailing address

700 E MOREHEAD ST STE 300
CHARLOTTE NC
28202-2742
US

V. Phone/Fax

Practice location:
  • Phone: 254-307-0252
  • Fax: 254-307-0257
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: KATRINA ROELLE
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 614-689-1691