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General NPI Number Information
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NPI Number | 1447384706
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Entity Type | Individual
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Provider Name | JULIE JACOB M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 8501 WADE BLVD STE 330
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City | FRISCO
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State | TX
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Zip | 75034-6264
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Country | US
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Telephone | 469-476-1444
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Fax | 972-987-5969
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Provider Business Mailing Address
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Address Line | 8501 WADE BLVD STE 330
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City | FRISCO
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State | TX
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Zip | 75034-6264
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Country | US
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Telephone | 469-476-1444
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Fax | 972-987-5969
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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 | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | M8055
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License Number State | TX
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