Provider Demographics
NPI:1679766216
Name:RBJPA,LLC
Entity Type:Organization
Organization Name:RBJPA,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:GWYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-344-1715
Mailing Address - Street 1:1517 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4932
Mailing Address - Country:US
Mailing Address - Phone:281-344-1715
Mailing Address - Fax:281-344-1716
Practice Address - Street 1:1517 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-4932
Practice Address - Country:US
Practice Address - Phone:281-344-1715
Practice Address - Fax:281-344-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty