MEDICARE: JSAM MEDICAL SUPPLY, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1447324207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JSAM MEDICAL SUPPLY, INC

Provider Business Mailing Address
First Line	:	593 S MASON RD
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-2437
Country	:	US
Telephone Number	:	281-398-7782
Fax Number	:	281-398-7783

Provider Business Practice Location Address
First Line	:	593 S MASON RD
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-2437
Country	:	US
Telephone Number	:	281-398-7782
Fax Number	:	281-398-7783

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JUAN JOSE MARTINEZ
Credential	:
Telephone Number	:	281-398-7782

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	04/04/2012

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Directions to “JSAM MEDICAL SUPPLY, INC ” Practice Location

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