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Individual

DR. JACOB CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
415 E SOUTHLAKE BLVD STE 101, SOUTHLAKE, TX 76092-6279
(817) 416-8080
Mailing address
455 NORTHWEST HWY APT 3302, IRVING, TX 75039-4245
(501) 920-3713

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
ME169949
FL
208600000X
Surgery Physician
E-15020
AR
208600000X
Surgery Physician
Primary
T5085
TX
208600000X
Surgery Physician
TRN27888
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/09/2014
Last updated
03/26/2026
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