Provider Demographics
NPI:1952912123
Name:JACOB, MERIN ANN (AUD)
Entity type:Individual
Prefix:DR
First Name:MERIN
Middle Name:ANN
Last Name:JACOB
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14140 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3842
Mailing Address - Country:US
Mailing Address - Phone:281-649-7000
Mailing Address - Fax:281-240-0030
Practice Address - Street 1:234 W CEDAR BAYOU LYNCHBURG RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9051
Practice Address - Country:US
Practice Address - Phone:281-420-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81127231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist