=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912861204
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JLKARE PEARLAND LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2025
-----------------------------------------------------
Last Update Date | 12/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11200 BROADWAY ST STE 2743
-----------------------------------------------------
City | PEARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77584-9787
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-426-1229
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11200 BROADWAY ST STE 2743
-----------------------------------------------------
City | PEARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77584-9787
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-426-1229
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | MR. JARED QUALLS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 970-426-1229
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------