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General NPI Number Information
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NPI Number | 1093431678
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Entity Type | Organization
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Legal Business Name | JEANM INTEGRATED HEALTH BILLING SOURCE
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 16303 N BEND DR
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City | HOUSTON
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State | TX
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Zip | 77073-5342
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Country | US
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Telephone | 832-779-2037
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Fax |
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Provider Business Mailing Address
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Address Line | 16303 N BEND DR
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City | HOUSTON
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State | TX
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Zip | 77073-5342
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Country | US
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Telephone | 832-779-2037
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEANETTE MCCORVEY
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Credential |
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Telephone | 281-975-7934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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