Active NPI
Brad Perry Jacobson, PHARMD
- Pharmacist
- Schertz, TX
National Provider Identifier
1063234664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 74862
- Practice address
- 5334 FM 1103
Schertz, TX 78108-2444 - Phone
- (210) 672-6596
- NPI assigned
- Oct 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 74862 | TX | Primary |
Addresses
Primary practice location
5334 FM 1103
Schertz, TX 78108-2444
Mailing address
922 E Sonterra Blvd Apt 3305
San Antonio, TX 78258-5008
Phone (702) 525-6989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74862 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Stafford, TX
- NPI 1427931351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729900800000",
"number": "1063234664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "922 E SONTERRA BLVD APT 3305",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782585008",
"telephone_number": "702-525-6989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5334 FM 1103",
"city": "SCHERTZ",
"state": "TX",
"postal_code": "781082444",
"telephone_number": "210-672-6596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "BRAD",
"middle_name": "PERRY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-26",
"last_updated": "2024-10-26",
"certification_date": "2024-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "74862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schertz, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.