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NPI Code Detail

MEDICARE: MARK A JACOBS MD PA

MEDICARE: MARK A JACOBS MD PA
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
1207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1861724197
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARK A JACOBS MD PA
Provider Business Mailing Address
First Line : PO BOX 540088
Second Line :
City : HOUSTON
State : TX
Zip : 77254-0088
Country : US
Telephone Number : 713-850-1190
Fax Number : 713-850-1327
Provider Business Practice Location Address
First Line : 7580 FANNIN ST STE 220
Second Line :
City : HOUSTON
State : TX
Zip : 77054-1939
Country : US
Telephone Number : 713-799-2515
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MARK JACOBS
Credential : MD
Telephone Number : 713-799-2515
Provider Enumeration Date : 02/11/2010
Last Update Date : 05/11/2023

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