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General NPI Number Information
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NPI Number | 1962670505
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Entity Type | Organization
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Legal Business Name | JACOB TAL, MD PA
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 23920 KATY FWY SUITE 460
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City | KATY
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State | TX
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Zip | 77494-1341
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Country | US
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Telephone | 713-464-1845
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Fax | 281-392-5081
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Provider Business Mailing Address
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Address Line | 23920 KATY FWY SUITE 460
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City | KATY
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State | TX
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Zip | 77494-1341
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Country | US
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Telephone | 713-464-1845
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Fax | 281-392-5081
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACOB TAL
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Credential | MD
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Telephone | 713-464-1845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | F7630
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License Number State | TX
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