Provider Demographics
NPI:1235286485
Name:YOUR TOTAL FOOT CARE SPECIALIST PA
Entity Type:Organization
Organization Name:YOUR TOTAL FOOT CARE SPECIALIST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-395-3338
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:813-953-3382
Practice Address - Fax:281-395-3496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1064213ES0103X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5476250001OtherMEDICARE NSC
TX185896101Medicaid
TX5476250001Medicare NSC
TX00088ZMedicare ID - Type Unspecified