Individual
JESSY SABU PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
8307 KNIGHT RD, HOUSTON, TX 77054
(713) 796-9955
Mailing address
PO BOX 3345, HOUSTON, TX 77253-3345
(713) 796-9955
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
685688
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP116034
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187942101
—
TX
Enumeration date
08/06/2007
Last updated
04/30/2019
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