Provider Demographics
NPI:1821154162
Name:JOVIC HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:JOVIC HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IBUKUNOLUIWA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-646-6692
Mailing Address - Street 1:13135 N BELLAIRE ESTATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-0363
Mailing Address - Country:US
Mailing Address - Phone:832-389-1205
Mailing Address - Fax:713-583-2300
Practice Address - Street 1:13135 N BELLAIRE ESTATE DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-0363
Practice Address - Country:US
Practice Address - Phone:832-389-1205
Practice Address - Fax:713-583-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009823251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679568Medicare ID - Type Unspecified