Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jacob Carlson, MD

Individual provider Surgery Physician · NPI 1568881282

Dr. Jacob Carlson, MD is a General Surgery in Southlake, Texas. Qualified in 2014, 12 years ago. Works from 3 locations. Licensed in Arkansas, Florida and Texas.

Years since qualifying
12
Licensed in
AR, FL, TX
In the registry since
2014
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

415 E Southlake Blvd Ste 101
Southlake, TX 76092-6279
Phone: (817) 416-8080
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4301 W Markham St, Little Rock, AR 72205-7101 — (501) 686-7000
  • 1600 Sw Archer Rd, Gainesville, FL 32610-3003 — (352) 273-8670

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence T5085 (TX)
Surgery Physician Taxonomy 208600000X · Licence E-15020 (AR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Plastic Surgery Physician Taxonomy 208200000X · Licence ME169949 (FL)
Surgery Physician Taxonomy 208600000X · Licence TRN27888 (FL)

Record details

NPI number1568881282
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 9, 2014
Last updated in NPPESMarch 26, 2026
Certification dateMarch 26, 2026
Mailing address455 Northwest Hwy Apt 3302, Irving, TX 75039-4245

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Not indicated

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