Individual
DR. MIKAEL JAMES JACOBSON
Active
Individual
DR. MIKAEL JAMES JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L5386
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164124306
—
TX
01
—
175829401
TMHP
TX
01
—
202949040
TRICARE PROVIDER ID
TX
01
—
551369
VALUE OPTIONS #
TX
01
—
8DJ721
BCBSTX
TX
01
—
8S7470
BCBS PROVIDER #
TX
01
—
L5386
TEXAS STATE LICENSE #
TX
Enumeration date
07/25/2006
Last updated
03/07/2023
Update your record
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