Provider Demographics
NPI:1831751775
Name:KPJ MANAGEMENT
Entity type:Organization
Organization Name:KPJ MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATINA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-447-3499
Mailing Address - Street 1:11301 RICHMOND AVE STE K103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5549
Mailing Address - Country:US
Mailing Address - Phone:281-679-6111
Mailing Address - Fax:
Practice Address - Street 1:11301 RICHMOND AVE STE K103
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5549
Practice Address - Country:US
Practice Address - Phone:281-679-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center