NPIMap

Organization Active NPI

Jerry S. Jacobs, O.D., P.C.

Doing business as Dr. Jerry Jacobs

  • Optometrist
  • Dallas, TX
National Provider Identifier
1811288020
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1781TG Issued in TX
Legal business name
JERRY S. JACOBS, O.D., P.C.
Doing business as
Dr. Jerry Jacobs
Practice address
1201 Elm St
Ste LL20
Dallas, TX 75270-2102
Phone
(214) 651-1000
Fax
(214) 651-1003
NPI assigned
Apr 21, 2011
Last updated
Sep 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Authorized official

Name
Dr. Jerry S Jacobs, O.D.
Title
President/Owner
Phone
(214) 651-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1781TG TX Primary

Addresses

Primary practice location

1201 Elm St
Ste LL20
Dallas, TX 75270-2102

Mailing address

1201 Elm St
Ste. LL20
Dallas, TX 75270-2102
Phone (214) 651-1000

Other names 1

  • Dr. Jerry Jacobs Doing business as

National Provider Directory

National Provider Directory

Locations

400 S Zang Blvd
Ste 804
Dallas, TX 75208
Phone (214) 941-8923

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1811288020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 ELM ST",
            "address_2": "STE. LL20",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752702102",
            "telephone_number": "214-651-1000",
            "fax_number": "214-651-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ELM ST",
            "address_2": "STE LL20",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752702102",
            "telephone_number": "214-651-1000",
            "fax_number": "214-651-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY S. JACOBS, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "214-651-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "1781TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Jerry Jacobs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.