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NPI Code Detail

MEDICARE: KJCARES, PLLC

MEDICARE: KJCARES, PLLC
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
1163WW0000XWound Care Registered Nurse
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
3363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1740748813
Entity Type Code : Organization
Provider Name (Legal Business Name) : KJCARES, PLLC
Provider Business Mailing Address
First Line : 2450 LOUISIANA ST STE 400
Second Line :
City : HOUSTON
State : TX
Zip : 77006-2318
Country : US
Telephone Number : 832-855-2696
Fax Number : 713-583-8095
Provider Business Practice Location Address
First Line : 2323 POLK ST APT 307
Second Line :
City : HOUSTON
State : TX
Zip : 77003-4407
Country : US
Telephone Number : 832-855-2696
Fax Number : 713-583-8095
Authorized Official
Title or Position : FAMILY NURSE PRACTITIONER
Name : MARY KABURU
Credential : FNP-BC
Telephone Number : 832-855-2696
Provider Enumeration Date : 03/07/2019
Last Update Date : 10/16/2023

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