Provider Demographics
NPI:1316291214
Name:JOBIN, LIJI (NP)
Entity type:Individual
Prefix:
First Name:LIJI
Middle Name:
Last Name:JOBIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LIJIMOL
Other - Middle Name:C
Other - Last Name:JACOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:12950 DALLAS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4235
Mailing Address - Country:US
Mailing Address - Phone:972-377-8695
Mailing Address - Fax:
Practice Address - Street 1:12950 DALLAS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4235
Practice Address - Country:US
Practice Address - Phone:972-377-8695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122403363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily