Provider Demographics
NPI:1669536330
Name:JACOBS, ROBERT L (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:JACOBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8285 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3358
Mailing Address - Country:US
Mailing Address - Phone:210-614-3923
Mailing Address - Fax:210-614-9306
Practice Address - Street 1:8285 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3358
Practice Address - Country:US
Practice Address - Phone:210-614-3923
Practice Address - Fax:210-614-9306
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1627207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89490BOtherBCBS
TX098221702Medicaid
TXC17368Medicare UPIN
TX0080AZMedicare PIN