Provider Demographics
NPI:1194548701
Name:TJL MEDICAL CONSULTING PLLC
Entity type:Organization
Organization Name:TJL MEDICAL CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TWILADAWN
Authorized Official - Middle Name:JUSTUS
Authorized Official - Last Name:LOVETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-722-0101
Mailing Address - Street 1:329 W COUGAR LN
Mailing Address - Street 2:
Mailing Address - City:CHINA SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:76633-2909
Mailing Address - Country:US
Mailing Address - Phone:254-722-0101
Mailing Address - Fax:254-221-7735
Practice Address - Street 1:329 W COUGAR LN
Practice Address - Street 2:
Practice Address - City:CHINA SPRING
Practice Address - State:TX
Practice Address - Zip Code:76633-2909
Practice Address - Country:US
Practice Address - Phone:254-722-0101
Practice Address - Fax:254-221-7735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-02
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty