Provider Demographics
NPI:1447537899
Name:JAYSTAL INC
Entity type:Organization
Organization Name:JAYSTAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BUCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-367-7371
Mailing Address - Street 1:6220 WESTPARK DR STE 207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7371
Mailing Address - Country:US
Mailing Address - Phone:713-367-7371
Mailing Address - Fax:713-422-2335
Practice Address - Street 1:6220 WESTPARK DR STE 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7371
Practice Address - Country:US
Practice Address - Phone:713-367-7371
Practice Address - Fax:713-422-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health