Provider Demographics
NPI:1437369873
Name:JACE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:JACE ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-498-0434
Mailing Address - Street 1:4606 FM 1960 RD W
Mailing Address - Street 2:SUITE 400 PMB # 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4604
Mailing Address - Country:US
Mailing Address - Phone:281-586-2298
Mailing Address - Fax:281-528-8440
Practice Address - Street 1:4606 FM 1960 RD W
Practice Address - Street 2:SUITE 400 PMB # 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4604
Practice Address - Country:US
Practice Address - Phone:281-586-2298
Practice Address - Fax:281-528-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056075225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty