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Individual

ROY G JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8400
Mailing address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8400

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
P7288
TX
2085P0229X
Pediatric Radiology Physician
25650
OK
2085P0229X
Pediatric Radiology Physician
Primary
P7288
TX
2085R0202X
Diagnostic Radiology Physician
25650
OK
2085R0202X
Diagnostic Radiology Physician
P7288
TX

Other

Enumeration date
06/20/2007
Last updated
03/11/2026
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