Healthcare Provider Details

I. General information

NPI: 1083401087
Provider Name (Legal Business Name): JASMINE NICOLE JOUBERT AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 MAIN ST
HOUSTON TX
77030-2351
US

IV. Provider business mailing address

3230 VISTA LAKE ST
SAN ANTONIO TX
78222-3326
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-1000
  • Fax:
Mailing address:
  • Phone: 210-649-5580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number1195101
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: