MEDICARE: JASSAN INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	508645	OTHER	TX	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780633123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JASSAN INC

Provider Business Mailing Address
First Line	:	3615 WILLOWBEND BLVD
Second Line	:	SUITE 424
City	:	HOUSTON
State	:	TX
Zip	:	77054-1115
Country	:	US
Telephone Number	:	713-660-9600
Fax Number	:	713-791-9352

Provider Business Practice Location Address
First Line	:	3615 WILLOWBEND BLVD
Second Line	:	SUITE 424
City	:	HOUSTON
State	:	TX
Zip	:	77054-1115
Country	:	US
Telephone Number	:	713-660-9600
Fax Number	:	713-791-9352

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	SANDRA R HOSKIN
Credential	:	RN,BS,MBA
Telephone Number	:	713-791-1841

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	09/23/2011

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Directions to “JASSAN INC ” Practice Location

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