Provider Demographics
NPI:1467732438
Name:JBCM-1
Entity Type:Organization
Organization Name:JBCM-1
Other - Org Name:HOUSTON MEDI-CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:T
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:713-633-1626
Mailing Address - Street 1:9402 MESA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-1201
Mailing Address - Country:US
Mailing Address - Phone:713-633-1626
Mailing Address - Fax:713-635-6253
Practice Address - Street 1:9402 MESA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-1201
Practice Address - Country:US
Practice Address - Phone:713-633-1626
Practice Address - Fax:713-635-6253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX774906163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty