Individual
JAKOB A DEVORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
5309 CORN FIELD DR, FORT WORTH, TX 76179-8163
(214) 227-2457
(214) 764-0880
Mailing address
5309 CORN FIELD DR, FORT WORTH, TX 76179-8163
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00729
TX
246ZS0410X
Surgical Technologist
142172
KS
Other
Enumeration date
05/05/2016
Last updated
09/10/2020
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