Individual
JENCY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390
(214) 645-0325
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP130147
TX
Other
Enumeration date
12/11/2015
Last updated
05/15/2018
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