Provider Demographics
NPI:1184103632
Name:SCHUMANN, JACOB GLENN (DC)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:GLENN
Last Name:SCHUMANN
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 1:1061 N COLEMAN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-2317
Mailing Address - Country:US
Mailing Address - Phone:972-818-5820
Mailing Address - Fax:
Practice Address - Street 1:1061 N COLEMAN ST STE 130
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2317
Practice Address - Country:US
Practice Address - Phone:972-818-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor