Provider Demographics
NPI:1801233309
Name:JKK EMG
Entity Type:Organization
Organization Name:JKK EMG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-324-5660
Mailing Address - Street 1:3625 CAMP BOWIE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-3351
Mailing Address - Country:US
Mailing Address - Phone:281-324-5660
Mailing Address - Fax:
Practice Address - Street 1:3625 CAMP BOWIE BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-3351
Practice Address - Country:US
Practice Address - Phone:281-324-5660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty