Organization
D. JARDIN HEALTHCARE - DIAGNOSTICS L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDI HERBOLARIO BACULI M.D, (PRESIDENT)
(972) 423-6715
Entity
Organization
Contact information
Practice address
1510 S AUSTIN ST, AMARILLO, TX 79102-2404
(972) 423-6715
(972) 578-1867
Mailing address
PO BOX 940092, PLANO, TX 75094-0092
(972) 423-6715
(972) 578-1867
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L2117
TX
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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