Provider Demographics
NPI:1922532803
Name:JACOBY, JILL HENZELL (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:HENZELL
Last Name:JACOBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:SEMPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:ONE BAYLOR PLZ
Mailing Address - Street 2:SUITE NC100, BCM MS:621
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-2222
Mailing Address - Fax:713-798-0111
Practice Address - Street 1:6501 FANNIN ST STE NC100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-798-2222
Practice Address - Fax:713-798-0111
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2997208M00000X, 207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice