Provider Demographics
NPI:1689905390
Name:TORRES, JACOB LISERIO (DC)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:LISERIO
Last Name:TORRES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W ASHBY PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5838
Mailing Address - Country:US
Mailing Address - Phone:210-468-1891
Mailing Address - Fax:105-684-9052
Practice Address - Street 1:120 W ASHBY PL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5838
Practice Address - Country:US
Practice Address - Phone:210-468-1891
Practice Address - Fax:210-568-4905
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor