Provider Demographics
NPI:1346349842
Name:COOMBS, JACQUIN ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUIN
Middle Name:ANN
Last Name:COOMBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10907 MEMORIAL HERMANN DR STE 490
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4114
Mailing Address - Country:US
Mailing Address - Phone:713-389-5520
Mailing Address - Fax:713-389-5521
Practice Address - Street 1:10907 MEMORIAL HERMANN DR
Practice Address - Street 2:STE 490
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4114
Practice Address - Country:US
Practice Address - Phone:713-389-5520
Practice Address - Fax:713-389-5521
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7340207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0007KTOtherBC BS
TX161564301Medicaid
TX609906Medicare ID - Type Unspecified
494454Medicare UPIN