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General NPI Number Information
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NPI Number | 1255993697
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Entity Type | Organization
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Legal Business Name | BJL LLC
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Dates
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Enumeration Date | 07/06/2019
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 11023 SOUTH COUNTRY CLUB GREEN DR
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City | TOMBALL
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State | TX
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Zip | 77375-7077
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Country | US
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Telephone | 832-639-8970
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Fax |
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Provider Business Mailing Address
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Address Line | 11023 SOUTH COUNTRY CLUB GREEN DR
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City | TOMBALL
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State | TX
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Zip | 77375-7077
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Country | US
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Telephone | 832-639-8970
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ADONIS TAYLOR
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Credential |
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Telephone | 713-960-2869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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