Jacob, Lisa Susan

Jacob, Lisa Susan is an individual health care provider with primary practice located at 1301 Barbara Jordan Blvd Suite 307, Austin TX 78723-3077. She recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Jacob, Lisa Susan can be contacted via phone (512) 324-9999.

Contact Information

Primary practice address
1301 Barbara Jordan Blvd Suite 307 Austin TX 78723-3077
Phone: (512) 324-9999
Fax: (512) 324-0645
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 19077 Texas
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 19077 Texas
Dental Providers / Pediatric Dentistry 1223P0221X 19077 Texas

Profile Details

NPI number 1386688331
LBN Legal business name Jacob, Lisa Susan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Dec 11th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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