Individual
MRS. KUSUMAM JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1643 SKYVIEW DR, IRVING, TX 75060-4711
(972) 790-9730
(972) 790-9732
Mailing address
1643 SKYVIEW DR, IRVING, TX 75060-4711
(972) 790-9730
(972) 790-9732
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
550058
TX
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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