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Individual
MARK JACOB
Active
Individual
MARK JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP130611
TX
Other
Enumeration date
08/25/2011
Last updated
02/02/2023
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