Provider Demographics
NPI:1528332095
Name:JTJS, LLP
Entity type:Organization
Organization Name:JTJS, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DESAUSSURE
Authorized Official - Middle Name:
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-686-4040
Mailing Address - Street 1:110 E SAVANNAH AVE BLDG A204
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1239
Mailing Address - Country:US
Mailing Address - Phone:956-686-4040
Mailing Address - Fax:956-630-6088
Practice Address - Street 1:118 FLACK STREET
Practice Address - Street 2:
Practice Address - City:FALFURRIAS
Practice Address - State:TX
Practice Address - Zip Code:78355
Practice Address - Country:US
Practice Address - Phone:956-686-4040
Practice Address - Fax:956-630-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty