=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568268944
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JJBPTX, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2025
-----------------------------------------------------
Last Update Date | 02/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2261 GATTIS SCHOOL RD STE 145
-----------------------------------------------------
City | ROUND ROCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78664-2881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-374-1414
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2261 GATTIS SCHOOL RD STE 145
-----------------------------------------------------
City | ROUND ROCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78664-2881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-374-1414
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ROBERT MICHAEL BOYD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 512-374-1414
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------