Provider Demographics
NPI:1205189198
Name:JNJM ENTERPRISE
Entity Type:Organization
Organization Name:JNJM ENTERPRISE
Other - Org Name:SYNTHERAPY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MONAL
Authorized Official - Middle Name:JANAK
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, MBA
Authorized Official - Phone:281-684-8535
Mailing Address - Street 1:PO BOX 1983
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77574-1983
Mailing Address - Country:US
Mailing Address - Phone:281-684-8535
Mailing Address - Fax:281-647-0649
Practice Address - Street 1:3455 STAGG DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4521
Practice Address - Country:US
Practice Address - Phone:281-684-8535
Practice Address - Fax:281-647-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center