Provider Demographics
NPI:1497388318
Name:JACOBS, ZACHARY SCOTT (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:SCOTT
Last Name:JACOBS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 MAIN POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3122
Mailing Address - Country:US
Mailing Address - Phone:979-251-2340
Mailing Address - Fax:
Practice Address - Street 1:17520 W GRAND PKWY S
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4758
Practice Address - Country:US
Practice Address - Phone:281-725-5895
Practice Address - Fax:281-725-5898
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13079612081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine