Individual
MR. JACOB ELLIS FORKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
7555 HOWELL SUGAR LAND RD, HOUSTON, TX 77083-3338
(281) 541-1849
Mailing address
5802 STERN SPRINGS LN, FULSHEAR, TX 77441-2049
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT3298
TX
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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