Doctor Name: | DR. JAMES MICHAEL JACOBS |
NPI Number: | 1033114822 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 1064 |
Business Practice Address: | 1331 W Grand Pkwy N #140 Katy, TX - 774932711 |
Business Phone Number: | 2813953338 |
Business Fax Number: | 2813953496 |
Mailing Address: | 1331 W Grand Pkwy N, #140 KATY |
State: | TX |
Postal Code: | 774932711 |
Phone Number: | 2813953338 |
Fax Number: | 2813953496 |
NPI Enumeration Date: | 06/17/2005 |
NPI Last Update Date: | 05/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/17/2006 |
NPI Reactivation Date: | 04/04/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | 1064 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |