Provider Demographics
NPI:1295816882
Name:JACOBS-RODRIGUEZ, ROBIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:JACOBS-RODRIGUEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:JACOBS-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2514 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4904
Mailing Address - Country:US
Mailing Address - Phone:281-485-8723
Mailing Address - Fax:281-485-8724
Practice Address - Street 1:2514 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4904
Practice Address - Country:US
Practice Address - Phone:281-485-8723
Practice Address - Fax:281-485-8724
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8140111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0059NEOtherBLUE CROSS/BLUE SHIELD ID
TX0059NEOtherBLUE CROSS/BLUE SHIELD ID