Healthcare Provider Details

I. General information

NPI: 1407317464
Provider Name (Legal Business Name): JACOB MICHAEL JONES DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2019
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20639 KUYKENDAHL RD STE 200
SPRING TX
77379-3587
US

IV. Provider business mailing address

20639 KUYKENDAHL RD STE 200
SPRING TX
77379-3587
US

V. Phone/Fax

Practice location:
  • Phone: 832-698-0111
  • Fax: 832-698-0150
Mailing address:
  • Phone: 832-598-0111
  • Fax: 832-698-0150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007010
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD455
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number692110
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: