Emilio Jacques Jr., MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

H9352 Issued in TX

Practice address

4602 Lorelei Dr
San Antonio, TX 78229-5034

Phone

(210) 589-6976

Fax

(210) 949-0311

NPI assigned

May 14, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• San Antonio Medical Clinic PA

  • Specialist
  • San Antonio, TX
  • NPI 1285856591
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1134447196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 LORELEI DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295034",
            "telephone_number": "210-589-6976",
            "fax_number": "210-949-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 LORELEI DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295034",
            "telephone_number": "210-589-6976",
            "fax_number": "210-949-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "EMILIO",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "H9352",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "H9352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "N0132476",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John David Jacobson, LPC
• Leah Jacobson, MD
• Mikael James Jacobson, M.D.
• Norman Labe Jacobson
• Alexandria Jacobus, FNP
• Tiffani Karrin Jacques
• Maria De Jesus Jacquez
• Jade DKR LLC
• Gayatri Jadhav
• Reshma Prashant Jadhav, MD

• Orthopaedic Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.