Provider Demographics
NPI:1598029464
Name:FALCON, JACOB (MD)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:FALCON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N I-35, SUITE C3.314
Mailing Address - Street 2:UT SOUTHWESTERN AUSTIN EM RESIDENCY PROGRAM
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701
Mailing Address - Country:US
Mailing Address - Phone:512-324-7000
Mailing Address - Fax:
Practice Address - Street 1:1400 NORTH ST # I-35
Practice Address - Street 2:C3.314
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2620
Practice Address - Country:US
Practice Address - Phone:512-324-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10042996207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine