| Doctor Name: | DR. JACOBUS J. WESTENBURG |
| NPI Number: | 1912915166 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | C3904 |
| Business Practice Address: | 107 Avenue C Ne Box 215 Childress, TX - 792014515 |
| Business Phone Number: | 9409378064 |
| Business Fax Number: | 9409379022 |
| Mailing Address: | 107 Ave. C Ne, P.o. Box 215 CHILDRESS |
| State: | TX |
| Postal Code: | 792019201 |
| Phone Number: | 9409378064 |
| Fax Number: | 9409379022 |
| NPI Enumeration Date: | 08/04/2006 |
| NPI Last Update Date: | 09/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C3904 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |