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General NPI Number Information
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NPI Number | 1194031641
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Entity Type | Individual
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Provider Name | SHANCY JACOB D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/22/2010
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 7616 BRANFORD PL STE 220
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City | SUGAR LAND
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State | TX
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Zip | 77479-3794
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Country | US
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Telephone | 713-530-3585
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Fax |
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Provider Business Mailing Address
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Address Line | 2895 RAGUSA LN
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City | LEAGUE CITY
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State | TX
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Zip | 77573-6130
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Country | US
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Telephone | 713-530-3585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | P2010
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License Number State | TX
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