SUZANNE JACOB (NPI# 1255867057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255867057 |
Entity Type | Individual |
Full Name | SUZANNE JACOB |
Credential | MD |
Practice Address |
2201 Macarthur Dr Ste 103 Waco TX 76708-3159 |
Mailing Address |
1600 Providence Dr Waco TX 76707-2261 |
Practice Telephone | 2543135300 |
Practice Fax Number | 2543135399 |
Mailing Telephone | 2543134200 |
Mailing Fax Number | 2543134549 |
Enumeration Date | 2017-05-11 |
Last Update Date | 2020-10-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | S8578 | TX | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
11234 Anderson St, Loma Linda, CA 923542804 | 9095582828 |
Street Address |
2201 MACARTHUR DR STE 103 |
City | WACO |
State | TX |
Zip Code | 76708-3159 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750340568 | Matthew Brian Bierwirth | Pediatrics | 2201 Macarthur Dr Ste 103, Waco, TX 76708 | 2006-03-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144868613 | Sarah Bogacz | Behavior Technician | 6824 Logue Lane, Bluesprig Pediatrics, Waco, TX 76708 | 2019-12-16 |
1700358215 | Albert Jacob Puente | Specialist/Technologist | 1101 North Q Ave, Clifton, TX 76708 | 2018-12-21 |
1437414810 | Cenikor Foundation | Substance Abuse Rehabilitation Facility | 3015 Herring Avenue, Waco, TX 76708 | 2012-07-11 |
1922393610 | Betty Hendricks | Nurse Practitioner | 4601 N 19th Street, Waco, TX 76708 | 2011-06-10 |
1023239498 | Esc Iv, Lp | Assisted Living Facility | 3801 Martin Luther King Jr Bvd, Waco, TX 76708 | 2007-05-01 |
1952429367 | Dod David Moore | Dentist | 10104 Saddle Creek Rd, Waco, TX 76708 | 2007-03-26 |
1851400295 | H-e-b, Lp | Clinical Medical Laboratory | 3801 N 19th St, Waco, TX 76708 | 2006-08-30 |
1972527257 | Meryl Burchardt | Nurse Practitioner | 2201 Macarthur, Suite 2200, Waco, TX 76708 | 2006-07-27 |
1669493292 | Central Texas Anesthesiology Associates Inc | Anesthesiology | 3000 Herring, Waco, TX 76708 | 2006-07-21 |
1679507768 | Russell L Mcclellan | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
Find all providers in zip 76708 |
Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023067303 | Mark A Lorenzen | Pediatrics | 301b Richland West Cir, Waco, TX 76712-7919 | 2006-05-06 |
1740246909 | Sue E. Stanko | Pediatrics | 1201 Hewitt Dr Ste 204, Waco, TX 76712-8834 | 2006-04-25 |
1750340568 | Matthew Brian Bierwirth | Pediatrics | 2201 Macarthur Dr Ste 103, Waco, TX 76708 | 2006-03-21 |
1720059272 | Charles Edward Gamble | Pediatrics | 2201 Macarthur, Ste 103, Waco, TX 76708 | 2006-01-31 |
1689645236 | Karen Cervenka Kemper | Pediatrics | 2201 Macarthur Dr, Suite 103, Waco, TX 76708-3161 | 2006-01-31 |
1346211893 | Jacquelin Dawn Dewbre | Pediatrics | 120 Hillcrest Medical Blvd Ste 100, Waco, TX 76712-8949 | 2006-01-31 |
1649257429 | Floyd Lee Barry | Pediatrics | 1911 Martin Luther King Blvd, Waco, TX 76704 | 2005-12-22 |
1962485516 | William R Nesmith | Pediatrics | 601 W Hwy 6, Suite 102, Waco, TX 76710-5591 | 2005-11-28 |
1770566333 | Stephen Chakmakjian | Pediatrics | 601 W State Highway 6, Suite 102, Waco, TX 76710-5591 | 2005-11-28 |
1861880080 | Heart of Texas Community Health Center, Inc | Pediatrics | 1600 Providence Dr, Waco, TX 76707-2261 | 2014-12-23 |
Find all providers in WACO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.