Provider Demographics
NPI:1760047617
Name:RY JAY Z LLC
Entity Type:Organization
Organization Name:RY JAY Z LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEESTRATEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-308-4336
Mailing Address - Street 1:3415 NORTH HERITAGE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-6634
Mailing Address - Country:US
Mailing Address - Phone:903-308-4336
Mailing Address - Fax:
Practice Address - Street 1:3415 NORTH HERITAGE PARKWAY
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-6634
Practice Address - Country:US
Practice Address - Phone:903-308-4336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty