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

Jacolby Thomas Whitaker

Individual provider Athletic Trainer · NPI 1164054482

Jacolby Thomas Whitaker is an Athletic Trainer in Alto, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2020
Specialties on file
2

Practice location Address checks out

8830 State Highway 21
Alto, TX 75925-6018
Phone: (903) 948-1074
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (TX)
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1164054482
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 5, 2020
Last updated in NPPESFebruary 5, 2020
Certification dateFebruary 5, 2020
Mailing address8830 State Highway 21, Alto, TX 75925-6018