Individual
JACOB VADAKEKALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5107 MEDICAL DR, SAN ANTONIO, TX 78229
(210) 614-8612
(210) 615-1666
Mailing address
5107 MEDICAL DR, SAN ANTONIO, TX 78229
(210) 614-8612
(210) 615-1666
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
K9443
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042891401
—
TX
Enumeration date
04/26/2006
Last updated
09/27/2023
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