Individual
SHAHEEN KAKA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4323 N JOSEY LN, SUITE 306, CARROLLTON, TX 75010-4633
(972) 939-7011
(972) 939-2951
Mailing address
4323 N JOSEY LN, SUITE 306, CARROLLTON, TX 75010-4633
(972) 939-7011
(972) 939-2951
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
P3736
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
309929YUD
MEDICARE PTAN
TX
05
—
327547101
—
TX
01
—
P3736
MEDICAL LICENSE
TX
Enumeration date
04/18/2008
Last updated
01/02/2016
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