Individual
JEROME L YAKLIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1005 HARBORSIDE DRIVE, GALVESTON, TX 77555-2722
(409) 772-9507
(409) 747-5570
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5303
(409) 772-1957
(937) 245-7999
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
S6330
TX
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
S6330
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1603210171
BCBSM
MI
05
—
4645433
—
MI
Enumeration date
07/12/2006
Last updated
03/28/2025
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