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General NPI Number Information
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NPI Number | 1801930045
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Entity Type | Organization
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Legal Business Name | JAEG BRIGHT MEDICAL SERVICES,INC.
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 6420 HILLCROFT ST SUITE 210
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City | HOUSTON
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State | TX
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Zip | 77081-3190
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Country | US
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Telephone | 713-779-7042
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Fax | 713-779-7093
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Provider Business Mailing Address
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Address Line | 6420 HILLCROFT ST SUITE 210
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City | HOUSTON
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State | TX
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Zip | 77081-3190
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Country | US
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Telephone | 713-779-7042
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Fax | 713-779-7093
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Authorized Official
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Title or Position | ADMINISTRATOR / DON
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Name | MS. TAMERIA LASHONDA KELLY-PENA
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Credential | RN
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Telephone | 713-779-7042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 014266
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License Number State | TX
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