Provider Demographics
NPI:1538029319
Name:FOUR K CDS, LLC
Entity type:Organization
Organization Name:FOUR K CDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PANNA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:512-221-3600
Mailing Address - Street 1:3510 MONSOON PATH
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4167
Mailing Address - Country:US
Mailing Address - Phone:512-221-3600
Mailing Address - Fax:800-616-9324
Practice Address - Street 1:2115 STEPHENS PL STE 700
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2162
Practice Address - Country:US
Practice Address - Phone:512-221-3600
Practice Address - Fax:800-616-9324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty