Provider Demographics
NPI:1164666780
Name:JACOBS, MARGARET A (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:JACOBS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12952 BANDERA RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4689
Mailing Address - Country:US
Mailing Address - Phone:210-372-9600
Mailing Address - Fax:210-372-0211
Practice Address - Street 1:5441 BABCOCK RD
Practice Address - Street 2:STE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3993
Practice Address - Country:US
Practice Address - Phone:210-253-3888
Practice Address - Fax:210-253-3889
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2011-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1078889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2097446Medicaid
TX819T66OtherBLUE CROSS BLUE SHIELD
TX819T66OtherBLUE CROSS BLUE SHIELD