Dhanya Mary Jacob, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

BP10090705 Issued in TX

Practice address

110 Memorial Hospital Dr
Huntsville, TX 77340-4940

Phone

(936) 291-4204

NPI assigned

May 28, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: dhanya.jacob.1@13218.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1427898592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 RAVENWOOD VILLAGE DR APT 621",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773401637",
            "telephone_number": "210-859-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MEMORIAL HOSPITAL DR",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404940",
            "telephone_number": "936-291-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "DHANYA",
        "middle_name": "MARY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10090705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premswarup Joel Immaraj, M.D.
• Infinite Vision, PLLC
• Interdiscipliinary Pain Management
• Internal Medicine Associates of Huntsville, PLLC
• Ja Robles & Associates Inc
• Dayana Noemi Jacome, AGACNP
• David S Jang
• Alannah Jenkins, M.S. SLP INTERN
• John E Pinkstaff M D PLLC
• Kellie Diann Johnson

• Family Medicine Physician in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.