Doctor Name: | JACOB JOHN NOVAK |
NPI Number: | 1043336381 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | K2766 |
Business Practice Address: | 2628 Long Prairie Rd Suite 107 Flower Mound, TX - 750224839 |
Business Phone Number: | 9728996666 |
Business Fax Number: | 9728996665 |
Mailing Address: | Po Box 961214, FORT WORTH |
State: | TX |
Postal Code: | 761610214 |
Phone Number: | 9728996666 |
Fax Number: | 9728996665 |
NPI Enumeration Date: | 03/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207PE0004X |
License Number: | K2766 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Emergency Medicine |
Taxonomy Specialization: | Emergency Medical Services |
Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |