Provider Demographics
NPI:1639310147
Name:JTP DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:JTP DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-557-2889
Mailing Address - Street 1:12840 HILLCREST PLAZA DRIVE
Mailing Address - Street 2:SUITE E100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1528
Mailing Address - Country:US
Mailing Address - Phone:214-341-8770
Mailing Address - Fax:214-341-1603
Practice Address - Street 1:12840 HILLCREST PLAZA DRIVE
Practice Address - Street 2:SUITE E100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1528
Practice Address - Country:US
Practice Address - Phone:214-341-8770
Practice Address - Fax:214-341-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology