MEDICARE: JOLIVET APRN MEDICAL LLC

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	261QH0100X	Health Service Clinic/Center
2	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1134847676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOLIVET APRN MEDICAL LLC

Provider Business Mailing Address
First Line	:	2045 SPACE PARK DR STE 235
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-6311
Country	:	US
Telephone Number	:	832-225-2709
Fax Number	:	409-217-5086

Provider Business Practice Location Address
First Line	:	2045 SPACE PARK DR STE 235
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-6311
Country	:	US
Telephone Number	:	832-225-2709
Fax Number	:	409-217-5086

Authorized Official
Title or Position	:	SOLE OWNER/HEALTHCARE PROVIDER
Name	:	MRS. ALEXIS JOLIVET-CHAMBERS
Credential	:	NURSE PRACTITIONER
Telephone Number	:	409-526-3741

Provider Enumeration Date	:	08/19/2022
Last Update Date	:	01/08/2026

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