Provider Demographics
NPI:1730626938
Name:JK RADIANT
Entity type:Organization
Organization Name:JK RADIANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRITNI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-973-3084
Mailing Address - Street 1:9802 FM 1960 BYPASS RD W
Mailing Address - Street 2:#100
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3501
Mailing Address - Country:US
Mailing Address - Phone:281-358-3800
Mailing Address - Fax:281-358-3910
Practice Address - Street 1:9802 FM 1960 BYPASS RD W
Practice Address - Street 2:#100
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3501
Practice Address - Country:US
Practice Address - Phone:281-358-3800
Practice Address - Fax:281-358-3910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty