MEDICARE: LIZETH JIMENEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		TX

General Provider Information

NPI Number	:	1023766326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIZETH JIMENEZ

Provider Business Mailing Address
First Line	:	12719 ENCHANTED PATH DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-1323
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12719 ENCHANTED PATH DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-1323
Country	:	US
Telephone Number	:	832-291-9499
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2022
Last Update Date	:	10/30/2025

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Directions to “ LIZETH JIMENEZ ” Practice Location

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