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NPI Code Detail

MEDICARE: RBJPA,LLC

MEDICARE: RBJPA,LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1679766216
Entity Type Code : Organization
Provider Name (Legal Business Name) : RBJPA,LLC
Provider Business Mailing Address
First Line : 1517 THOMPSON RD
Second Line :
City : RICHMOND
State : TX
Zip : 77469-4932
Country : US
Telephone Number : 281-344-1715
Fax Number : 281-344-1716
Provider Business Practice Location Address
First Line : 1517 THOMPSON RD
Second Line :
City : RICHMOND
State : TX
Zip : 77469-4932
Country : US
Telephone Number : 281-344-1715
Fax Number : 281-344-1716
Authorized Official
Title or Position : ADMINISTRATION
Name : GWYNNE SURY
Credential :
Telephone Number : 281-344-1715
Provider Enumeration Date : 08/27/2007
Last Update Date : 06/20/2008

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