MEDICARE: JTB MEDICAL EQUIPMENT & SERVICES, INC.

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	332BX2000X	Oxygen Equipment & Supplies (DME)	0094090	TX

General Provider Information

NPI Number	:	1194847582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JTB MEDICAL EQUIPMENT & SERVICES, INC.

Provider Business Mailing Address
First Line	:	9950 WESTPARK DR
Second Line	:	338
City	:	HOUSTON
State	:	TX
Zip	:	77063-5138
Country	:	US
Telephone Number	:	713-808-9811
Fax Number	:	713-808-9756

Provider Business Practice Location Address
First Line	:	9950 WESTPARK DR
Second Line	:	338
City	:	HOUSTON
State	:	TX
Zip	:	77063-5138
Country	:	US
Telephone Number	:	713-808-9811
Fax Number	:	713-808-9756

Authorized Official
Title or Position	:	ADMIN DIRECOTOR/PRESIDENT
Name	:	JACQUELINE L MCCAMPBELL
Credential	:
Telephone Number	:	713-808-9811

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	08/27/2008

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