Individual
RYAN J JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 E CENTRAL TEXAS EXPY STE 101, KILLEEN, TX 76543-7326
(254) 741-6641
(254) 537-4693
Mailing address
101 W LOUIS HENNA BLVD STE 300, AUSTIN, TX 78728-1203
(512) 244-4272
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036-153211
IL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
T7112
TX
208VP0014X
Interventional Pain Medicine Physician
T7112
TX
Other
Enumeration date
04/26/2016
Last updated
08/15/2023
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