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General NPI Number Information
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NPI Number | 1306437942
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Entity Type | Individual
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Provider Name | JASMINE SELINA DELANCY PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 5333 WESTHEIMER RD STE 560
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City | HOUSTON
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State | TX
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Zip | 77056-5407
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Country | US
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Telephone | 713-960-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 4410 1/2 BUCK ST APT A
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City | HOUSTON
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State | TX
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Zip | 77020-7156
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Country | US
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Telephone | 832-286-7419
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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 | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | PA13983
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License Number State | TX
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