Individual
DR. JERRY S JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D. PC
Contact information
Practice address
400 S ZANG BLVD, STE 804, DALLAS, TX 75208-6643
(214) 941-8923
(214) 941-4887
Mailing address
400 S ZANG BLVD, STE 804, DALLAS, TX 75208-6643
(214) 941-8923
(214) 941-4887
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1781TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E22C
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/14/2006
Last updated
06/14/2016
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