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General NPI Number Information
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NPI Number | 1780165845
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Entity Type | Organization
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Legal Business Name | BTDI JV LLP
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 7217 TELECOM PKWY STE 150
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City | GARLAND
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State | TX
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Zip | 75044-2202
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Country | US
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Telephone | 972-495-7756
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746003
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City | ATLANTA
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State | GA
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Zip | 30374-6003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | KATE ROELLE
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Credential |
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Telephone | 614-689-1691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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