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General NPI Number Information
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NPI Number | 1023275823
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Entity Type | Organization
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Legal Business Name | DJ GLOBAL SOLUTIONS LLC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 4015 S TEXAS AVE
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City | BRYAN
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State | TX
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Zip | 77802-4022
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Country | US
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Telephone | 979-220-3854
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Fax | 979-260-1052
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Provider Business Mailing Address
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Address Line | 4015 SOUTH TEXAS AVENUE
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City | BRYAN
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State | TX
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Zip | 77802-4022
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Country | US
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Telephone | 979-220-3854
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Fax | 979-260-1052
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Authorized Official
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Title or Position | CO OWNER
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Name | MRS. DONNA GAYLE HARRIS
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Credential | MEDICAL ASSISTANT
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Telephone | 979-260-1024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D1071963
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License Number State | TX
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