MEDICARE: SHEAN NICOLE CABALLERO JACOT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1407755	TX
2	225100000X	Physical Therapist	013572	CT

General Provider Information

NPI Number	:	1114796182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEAN NICOLE CABALLERO JACOT

Provider Business Mailing Address
First Line	:	6700 HOLLISTER ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-5331
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 HOLLISTER ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-5331
Country	:	US
Telephone Number	:	713-718-9168
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2024
Last Update Date	:	02/09/2026

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Directions to “ SHEAN NICOLE CABALLERO JACOT ” Practice Location

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