Individual
HEIDI JACOBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-9069
(214) 648-2985
(214) 648-9292
Mailing address
5323 HARRY HINES BLVD, DALLAS, TX 75390-9069
(214) 648-2985
(214) 648-9292
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
K5314
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153700301
—
TX
Enumeration date
03/23/2006
Last updated
02/15/2011
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