Jacob, Shushan

Jacob, Shushan is an sole proprietor health care provider with primary practice located at 1668 Keller Pkwy Ste 300 , Keller TX 76248-3710. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgery of the Hand. Allopathic & Osteopathic Physicians / Surgery of the Hand is her primary health care specialty. Jacob, Shushan can be contacted via phone (817) 404-4811.

Contact Information

Primary practice address
1668 Keller Pkwy Ste 300 Keller TX 76248-3710
Phone: (817) 404-4811
Fax: (833) 974-2284
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X N7548 Texas
Allopathic & Osteopathic Physicians / Surgery of the Hand 2086S0105X N7548 Texas

Profile Details

NPI number 1114119542
LBN Legal business name Jacob, Shushan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2007
Last updated Sep 28th, 2022 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1114119542 NPPES
Texas MEDICAID 286943004
Texas MEDICAID 286943005

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