Individual
DR. CAROL L JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 OGLETREE DR, LIVINGSTON, TX 77351-6783
(936) 328-8812
(936) 328-8815
Mailing address
400 OGLETREE DR, LIVINGSTON, TX 77351-6783
(936) 328-8812
(936) 328-8815
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
J6500
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092234604
—
TX
05
—
169920902
—
TX
01
—
7813
CHOICE ONE CHIPS
TX
01
—
8P9490
BCBS
TX
Enumeration date
09/21/2006
Last updated
03/21/2011
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