Active NPI
Justin S Jacobs Jr.
- Pharmacy Technician
- San Antonio, TX
National Provider Identifier
1891465159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 310877
- Practice address
- 6580 FM 78
San Antonio, TX 78244-1300 - Phone
- (210) 666-2121
- NPI assigned
- Sep 17, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 310877 | TX | Primary |
Addresses
Primary practice location
6580 FM 78
San Antonio, TX 78244-1300
Mailing address
401 Holland Ave Apt 130
San Antonio, TX 78212-2427
Phone (530) 908-5347
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 310877 | TX | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H-E-B, LP | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701388800000",
"number": "1891465159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 HOLLAND AVE APT 130",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782122427",
"telephone_number": "530-908-5347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6580 FM 78",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782441300",
"telephone_number": "210-666-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "JUSTIN",
"middle_name": "S",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-17",
"last_updated": "2023-12-01",
"certification_date": "2023-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "TX",
"license": "310877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.