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General NPI Number Information
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NPI Number | 1518464536
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Entity Type | Individual
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Provider Name | JACOB KEUP AUD
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Gender | Male
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1340 WONDER WORLD DR STE 2300
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City | SAN MARCOS
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State | TX
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Zip | 78666-8070
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Country | US
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Telephone | 737-221-8212
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 WONDER WORLD DR
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City | SAN MARCOS
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State | TX
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Zip | 78666-7598
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Country | US
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Telephone | 830-240-2826
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 80976
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License Number State | TX
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