Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | J9107 | TX |
NPI | 1033150602 |
---|---|
Provider Name | Dr. Philip M Jacobs |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-3931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 18/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
117795804 | (05) | TX |
117795806 | (05) | TX |
117795807 | CSHCN (01) | TX |
543710YK00 | (02) | TX |
5599663 | AETNA (01) | TX |
8K6275 | BCBS (01) | TX |
9274819 | CIGNA (01) | TX |
G20638 | (02) | TX |
P00062671 | RAILROAD MEDICARE (01) | TX |