Provider Demographics
NPI:1336382795
Name:YO, JACOB (LAC)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:YO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16525 LEXINGTON BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2577
Mailing Address - Country:US
Mailing Address - Phone:832-382-2686
Mailing Address - Fax:512-410-2322
Practice Address - Street 1:16525 LEXINGTON BLVD STE 220
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2577
Practice Address - Country:US
Practice Address - Phone:832-382-2686
Practice Address - Fax:512-410-2322
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01073171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist