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Individual

LISHA JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6201 HARRY HINES BLVD, DALLAS, TX 75235-5202
(214) 645-8300
Mailing address
2049 LAKE BEND DR, IRVING, TX 75060-7743
(214) 780-6061

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
916213
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1213293
TX

Other

Enumeration date
10/11/2022
Last updated
03/02/2026
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