MEDICARE: JAEG BRIGHT MEDICAL 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	251E00000X	Home Health Agency	014266	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801930045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAEG BRIGHT MEDICAL SERVICES,INC.

Provider Business Mailing Address
First Line	:	6420 HILLCROFT ST
Second Line	:	SUITE 210
City	:	HOUSTON
State	:	TX
Zip	:	77081-3190
Country	:	US
Telephone Number	:	713-779-7042
Fax Number	:	713-779-7093

Provider Business Practice Location Address
First Line	:	6420 HILLCROFT ST
Second Line	:	SUITE 210
City	:	HOUSTON
State	:	TX
Zip	:	77081-3190
Country	:	US
Telephone Number	:	713-779-7042
Fax Number	:	713-779-7093

Authorized Official
Title or Position	:	ADMINISTRATOR / DON
Name	:	MS. TAMERIA LASHONDA KELLY-PENA
Credential	:	RN
Telephone Number	:	713-779-7042

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	01/16/2013

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