MEDICARE: KPJ MANAGEMENT

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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1831751775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KPJ MANAGEMENT

Provider Business Mailing Address
First Line	:	11301 RICHMOND AVE STE K103
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-5549
Country	:	US
Telephone Number	:	281-679-6111
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 RICHMOND AVE STE K103
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-5549
Country	:	US
Telephone Number	:	281-679-6111
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KATINA DIANE JIMENEZ
Credential	:	DC
Telephone Number	:	713-447-3499

Provider Enumeration Date	:	07/01/2019
Last Update Date	:	07/01/2019

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Directions to “KPJ MANAGEMENT ” Practice Location

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