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General NPI Number Information
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NPI Number | 1952834723
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Entity Type | Individual
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Provider Name | JACOB TAUSIANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 08/28/2022
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Provider Practice Location Address
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Address Line | 12222 MERIT DR STE 600
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City | DALLAS
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State | TX
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Zip | 75251-3294
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Country | US
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Telephone | 855-464-8727
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Fax |
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Provider Business Mailing Address
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Address Line | 3584 HATHAWAY CT
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City | IRVING
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State | TX
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Zip | 75062-4383
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Country | US
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Telephone | 915-217-7649
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | S6958
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License Number State | TX
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