Healthcare Provider Details

I. General information

NPI: 1093710154
Provider Name (Legal Business Name): JMV ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 SANGER AVE STE 106
WACO TX
76710-7737
US

IV. Provider business mailing address

6701 SANGER AVE STE 106
WACO TX
76710-7737
US

V. Phone/Fax

Practice location:
  • Phone: 254-751-9393
  • Fax: 254-751-7441
Mailing address:
  • Phone: 254-751-9393
  • Fax: 254-751-7441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number002628
License Number StateTX

VIII. Authorized Official

Name: MR. JAMES MAREK
Title or Position: EXEC. VICE PRESIDENT
Credential:
Phone: 254-751-9393