Provider Demographics
NPI:1669721379
Name:KRJ BILLING & PRACTICE MANAGEMENT
Entity type:Organization
Organization Name:KRJ BILLING & PRACTICE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANUELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:NRCCS
Authorized Official - Phone:469-426-8683
Mailing Address - Street 1:PO BOX 618
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-0618
Mailing Address - Country:US
Mailing Address - Phone:469-426-8683
Mailing Address - Fax:469-453-3411
Practice Address - Street 1:701 ALLEN RD
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3144
Practice Address - Country:US
Practice Address - Phone:469-426-8683
Practice Address - Fax:469-453-3411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty