Individual
MELISSA FORBES JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
1535
SC
363AM0700X
Medical Physician Assistant
Primary
PA07478
TX
363AM0700X
Medical Physician Assistant
TL1535
SC
Other
Enumeration date
07/08/2010
Last updated
10/10/2019
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