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General NPI Number Information
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NPI Number | 1114208733
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Entity Type | Organization
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Legal Business Name | H. NEIL JACOBSON, MD PA
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 17440 DALLAS PKWY SUITE 208
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City | DALLAS
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State | TX
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Zip | 75287-7336
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Country | US
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Telephone | 972-248-1717
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Fax | 972-248-4599
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Provider Business Mailing Address
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Address Line | 17440 DALLAS PKWY SUITE 208
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City | DALLAS
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State | TX
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Zip | 75287-7336
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Country | US
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Telephone | 972-248-1717
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Fax | 972-248-4599
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Authorized Official
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Title or Position | OWNER
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Name | H. NEIL JACOBSON
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Credential | MD
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Telephone | 972-248-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G7244
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License Number State | TX
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