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General NPI Number Information
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NPI Number | 1932928652
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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 | 10/09/2024
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 922 S 10TH ST STE 210
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City | WACO
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State | TX
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Zip | 76706-1388
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Country | US
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Telephone | 254-307-0252
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Fax | 254-307-0257
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Provider Business Mailing Address
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Address Line | 700 E MOREHEAD ST STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28202-2742
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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 | KATRINA 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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