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General NPI Number Information
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NPI Number | 1659875573
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Entity Type | Individual
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Provider Name | JACOB WESLEY FLEMING MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 1441 N BECKLEY AVE
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City | DALLAS
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State | TX
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Zip | 75203-1201
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Country | US
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Telephone | 214-269-5775
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Fax | 214-269-5775
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Provider Business Mailing Address
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Address Line | 815 PENNSYLVANIA AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-2294
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Country | US
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Telephone | 214-269-5775
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Fax | 214-269-5775
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | S2773
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License Number State | TX
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