Healthcare Provider Details

I. General information

NPI: 1952221988
Provider Name (Legal Business Name): JAZAN INFORMATION TECHNOLOGY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 CAPITOL AVE STE 310A526
CHEYENNE WY
82001-4569
US

IV. Provider business mailing address

2781 CLUB RIDGE DR
LEWISVILLE TX
75067-8366
US

V. Phone/Fax

Practice location:
  • Phone: 21-383-4809
  • Fax:
Mailing address:
  • Phone: 213-834-8091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KHIZER ALI
Title or Position: OWNER
Credential:
Phone: 213-834-8091