Individual
DR. SHUSHAN JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6900 N PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9000
Mailing address
2140 E SOUTHLAKE BLVD STE L-605, SOUTHLAKE, TX 76092-6516
(267) 408-9036
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
N7548
TX
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
N7548
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286943004
—
TX
05
—
286943005
—
TX
Enumeration date
08/09/2007
Last updated
02/27/2025
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