Individual ProviderJacob LabahnFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address333 N Santa Rosa Ave, Center For Children & Families, 4th Floor, Clinic A, San Antonio, TX 78207-3108(210) 704-4140(210) 704-2535PECOS EnrollmentBased on the most recent information from CMS, provider Jacob Labahn does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1568595411Provider TypeIndividualFull NameLabahn, JacobTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date3/13/2007Last Updated5/16/2011Contact InformationPractice LocationPractice Address333 N Santa Rosa Ave, Center For Children & Families, 4th Floor, Clinic A, San Antonio, TX 78207-3108Phone(210) 704-4140Fax(210) 704-4142Mailing LocationMailing Address333 N Santa Rosa Ave Ste F4703, San Antonio, TX 78207-3108Phone(210) 704-2535Fax(210) 704-2545Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseM4846Texas