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General NPI Number Information
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NPI Number | 1235719295
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Entity Type | Individual
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Provider Name | ANNMARIE ROSE JAGHAB DO
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Gender | Female
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 7400 MERTON MINTER BLVD
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4404
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Country | US
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Telephone | 516-205-5770
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Fax |
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Provider Business Mailing Address
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Address Line | 12631 VANCE JACKSON RD APT 6305
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City | SAN ANTONIO
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State | TX
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Zip | 78230-6087
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Country | US
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Telephone | 516-205-5770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | V5779
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License Number State | TX
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