Healthcare Provider Details

I. General information

NPI: 1598655201
Provider Name (Legal Business Name): JKM HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N COLLEGE AVE STE 1407
TYLER TX
75702-7244
US

IV. Provider business mailing address

110 N COLLEGE AVE STE 1407
TYLER TX
75702-7244
US

V. Phone/Fax

Practice location:
  • Phone: 903-590-7513
  • Fax: 903-590-7513
Mailing address:
  • Phone: 903-590-7513
  • Fax: 903-590-7513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE MOONEY
Title or Position: DIRECTOR
Credential:
Phone: 903-590-7513