Provider Demographics
NPI:1033114822
Name:JACOBS, JAMES MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:JACOBS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23230 RED RIVER DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2046
Mailing Address - Country:US
Mailing Address - Phone:281-221-0662
Mailing Address - Fax:
Practice Address - Street 1:23230 RED RIVER DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2046
Practice Address - Country:US
Practice Address - Phone:281-395-3338
Practice Address - Fax:281-395-3496
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2022-01-06
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
TX1064213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018651201OtherMEDICAID PIN
TX081651201Medicaid
TX5476250001OtherMEDICARE NSC
TX8J5283Medicare PIN
TX8J5281Medicare PIN
TX8F0534Medicare PIN
TX8J5278Medicare PIN
TX8J5284Medicare PIN
TX8J5279Medicare PIN
TXU13007Medicare UPIN
TX018651201OtherMEDICAID PIN
TX8J5280Medicare PIN
TX8J5282Medicare PIN