MEDICARE: SJHEALTHCARE PROVIDER SERVICES INC

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
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467270207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SJHEALTHCARE PROVIDER SERVICES INC

Provider Business Mailing Address
First Line	:	29522 BRYANS MNR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-5547
Country	:	US
Telephone Number	:	346-614-5707
Fax Number	:

Provider Business Practice Location Address
First Line	:	29522 BRYANS MNR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-5547
Country	:	US
Telephone Number	:	281-794-0433
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SOPHIA JIBUIKE
Credential	:
Telephone Number	:	346-614-5707

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	12/08/2025

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Directions to “SJHEALTHCARE PROVIDER SERVICES INC ” Practice Location

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