MEDICARE: KIZMET HQ LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831030626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIZMET HQ LLC

Provider Business Mailing Address
First Line	:	5900 BALCONES DR STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4298
Country	:	US
Telephone Number	:	832-833-6463
Fax Number	:

Provider Business Practice Location Address
First Line	:	3239 ATHERTON CANYON LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1473
Country	:	US
Telephone Number	:	832-833-6463
Fax Number	:

Authorized Official
Title or Position	:	OWNER/EXECUTIVE DIRECTOR
Name	:	ANDREA JACKSON
Credential	:
Telephone Number	:	832-833-6463

Provider Enumeration Date	:	04/03/2026
Last Update Date	:	04/03/2026

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Directions to “KIZMET HQ LLC ” Practice Location

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