Individual
MARIAMMA M JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
7800 PRESTON RD STE 300, PLANO, TX 75024-3236
(972) 608-3800
(972) 608-3810
Mailing address
7800 PRESTON RD STE 300, PLANO, TX 75024-3236
(972) 608-3800
(972) 608-3810
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
557515
TX
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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