Theresa Jassim Jacob, MSN, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP119331 Issued in TX

Practice address

24275 Katy Fwy Ste 400
Katy, TX 77494-7267

Phone

(346) 387-7171

Fax

(844) 703-5305

NPI assigned

Aug 31, 2010

Last updated

Jan 31, 2018By the provider in NPPES

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)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1538476387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24275 KATY FWY STE 400",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947267",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24275 KATY FWY STE 400",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947267",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "THERESA",
        "middle_name": "JASSIM",
        "name_prefix": "Mrs.",
        "credential": "MSN, GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP119331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyechiela Jackson
• Jacky Home Health LLC (Jacky Home Care)
• Jacob Tal, MD PA
• Cindy S Jacob, MD
• Lorraine Vinitha Jacob, D.D.S.
• Ju Young Jacobo
• James Michael Jacobs, DPM
• Kimberly Suzanne Jacobson, R.D.
• Claire Natali Jacot, CLC
• Jacques Healthcare Services, LLC.

• Gerontology Nurse Practitioner in Katy, TX
• Providers in Katy, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.