Individual
JACOB TAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23960 KATY FWY, SUITE 350, KATY, TX 77494-1339
(713) 464-1845
(281) 392-5081
Mailing address
23960 KATY FWY, SUITE 350, KATY, TX 77494-1339
(713) 464-1845
(281) 392-5081
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F7630
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0025NG
BCBS
TX
05
—
179782101
—
TX
Enumeration date
08/01/2005
Last updated
12/02/2016
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