Provider Demographics
NPI:1649657305
Name:JACOB, JASMIN (FNP-BC)
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:JACOB
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16902 SOUTHWEST FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3574
Mailing Address - Country:US
Mailing Address - Phone:281-565-2800
Mailing Address - Fax:281-565-2801
Practice Address - Street 1:16902 SOUTHWEST FWY STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3574
Practice Address - Country:US
Practice Address - Phone:281-565-2800
Practice Address - Fax:281-565-2801
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily