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NPI Code Detail

MEDICARE: JAMARQUAN HOUSTON

MEDICARE:   JAMARQUAN  HOUSTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorWI

General Provider Information

NPI Number : 1356133342
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMARQUAN HOUSTON
Provider Business Mailing Address
First Line : 5273 N 65TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53218-3009
Country : US
Telephone Number : 262-207-4105
Fax Number :
Provider Business Practice Location Address
First Line : 5273 N 65TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53218-3009
Country : US
Telephone Number : 262-207-4105
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2025
Last Update Date : 05/19/2025

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Directions to “ JAMARQUAN HOUSTON ” Practice Location

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