1710356266 NPI number — JB3 INNOVATIONS, LLC

Table of content: JACK DONOVAN SINKEL RRT (NPI 1669010716)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710356266 NPI number — JB3 INNOVATIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JB3 INNOVATIONS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710356266
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6140 HIGHWAY 6 STE 209
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSOURI CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77459-3802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-224-6160
Provider Business Mailing Address Fax Number:
888-224-6160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
802 SUMMER PARK DR STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STAFFORD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77477-5573
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-224-6160
Provider Business Practice Location Address Fax Number:
888-224-6160
Provider Enumeration Date:
09/15/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BENDER
Authorized Official First Name:
JONATHAN
Authorized Official Middle Name:
Authorized Official Title or Position:
FOUNDER
Authorized Official Telephone Number:
303-324-2856

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)