Individual
DAVID MICHAEL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
214 WATLINGTON ST, CENTER, TX 75935-4348
(936) 427-7509
Mailing address
214 WATLINGTON ST, CENTER, TX 75935-4348
(936) 427-7509
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1026734
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026734
TEXAS BOARD OF NURSING
TX
Enumeration date
04/01/2021
Last updated
04/01/2021
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