Most Relevant Information
Provider Data
| NPI Number: | 1003562844 |
| Provider Name: | SOPHIA JACOB PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA15164 |
Most Important Dates
| Enumeration Date: | 03/01/2022 |
| Last Updated: | 04/27/2022 |
Provider Practice Location
1515 HOLCOMBE BLVD
HOUSTON
TX
770304000
Practice Location Phone/Fax
| Phone: | 7137926161 |
| Fax: |
Provider Mailing Location
PO BOX 4439
HOUSTON
TX
772104439
Provider Mailing Phone/Fax
| Phone: | 7137922991 |
| Fax: |