MEDICARE: DR. JACQUIN ANN COOMBS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	L7340	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0007KT	OTHER	TX	BC BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346349842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUIN ANN COOMBS MD

Provider Business Mailing Address
First Line	:	10907 MEMORIAL HERMANN DR STE 490
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-4114
Country	:	US
Telephone Number	:	713-389-5520
Fax Number	:	713-389-5521

Provider Business Practice Location Address
First Line	:	10907 MEMORIAL HERMANN DR
Second Line	:	STE 490
City	:	PEARLAND
State	:	TX
Zip	:	77584-4114
Country	:	US
Telephone Number	:	713-389-5520
Fax Number	:	713-389-5521

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	11/18/2019

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