Provider Demographics
NPI:1740555440
Name:TJA MANAGEMENT, LLC
Entity type:Organization
Organization Name:TJA MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-375-5914
Mailing Address - Street 1:1600 AIRPORT FWY STE 503
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6882
Mailing Address - Country:US
Mailing Address - Phone:210-375-5914
Mailing Address - Fax:210-375-5919
Practice Address - Street 1:1752 SANTE FE STREET
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-1857
Practice Address - Country:US
Practice Address - Phone:361-444-6888
Practice Address - Fax:361-252-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based