Provider Demographics
NPI:1306437942
Name:DELANCY, JASMINE SELINA (PA-C)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:SELINA
Last Name:DELANCY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 1/2 BUCK ST APT A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-7156
Mailing Address - Country:US
Mailing Address - Phone:832-286-7419
Mailing Address - Fax:
Practice Address - Street 1:5333 WESTHEIMER RD STE 560
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5407
Practice Address - Country:US
Practice Address - Phone:713-960-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13983207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology