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Organization

JC MEDICAL ENTERPRISES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLYN YVONNE HACKNEY (BILLING MANAGER)
(817) 800-8386
Entity
Organization

Contact information

Practice address
10240 KNIGHTS CT, KELLER, TX 76248-5027
(817) 800-8386
(817) 295-4992
Mailing address
10240 KNIGHTS CT, KELLER, TX 76248-5027
(817) 800-8386
(817) 295-4992

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
544119
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0052HT
BCBS OF TX
TX
Enumeration date
08/17/2006
Last updated
08/22/2020
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