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General NPI Number Information
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NPI Number | 1801233309
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Entity Type | Organization
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Legal Business Name | JKK EMG
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Dates
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Enumeration Date | 05/24/2013
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 3625 CAMP BOWIE BLVD
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City | FORT WORTH
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State | TX
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Zip | 76107-3351
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Country | US
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Telephone | 281-324-5660
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Fax |
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Provider Business Mailing Address
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Address Line | 3625 CAMP BOWIE BLVD
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City | FORT WORTH
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State | TX
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Zip | 76107-3351
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Country | US
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Telephone | 281-324-5660
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Fax |
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Authorized Official
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Title or Position | OWNR
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Name | JAMES KEVIN KAUFMAN
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Credential |
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Telephone | 281-324-5660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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