Provider Demographics
NPI:1972743003
Name:JFRM LLC
Entity Type:Organization
Organization Name:JFRM LLC
Other - Org Name:BLUEBONNET DIAGNOSTIC AND 3D IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FABRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-310-7177
Mailing Address - Street 1:208 W BAGDAD AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-5800
Mailing Address - Country:US
Mailing Address - Phone:512-341-2366
Mailing Address - Fax:512-246-0045
Practice Address - Street 1:208 W BAGDAD AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5800
Practice Address - Country:US
Practice Address - Phone:512-341-2366
Practice Address - Fax:512-341-2357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center