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Active NPI 1568881282 Individual Practitioner Male Practitioner

Dr. Jacob Carlson , MD

Surgery • Southlake, TX

Professional Overview & Biography Verified Profile Summary

Dr. Jacob Carlson, MD is a certified Surgery practicing in Southlake, TX. With approximately 12 years of clinical experience since completing medical education in 2014, Dr. Carlson delivers high-quality medical care to the local community at 415 E SOUTHLAKE BLVD STE 101.

Dr. Carlson does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

415 E Southlake Blvd Ste 101

Southlake, TX 760926279

Telephone 8174168080
Associated Practice Facility / Clinic
🏢 Virtuoso Surgery Center Facility NPI 1376942987

Medicare Profile & Education

Medical School

Other

Graduation Year

2014

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Southlake, TX

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
12 Yrs -3.7 yrs vs City Avg
City Avg: 15.7 Yrs
State Avg: 25.2 Yrs
Regional Practice Density
6 Specialists

Practicing in Southlake, TX (2342 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Carlson (12 Years) 12 Yrs
Southlake Specialty Average (15.7 Years) 15.7 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-03-26
Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License TX T5085

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License AR E-15020

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Plastic Surgery

NUCC Taxonomy Code: 208200000X

State License FL ME169949

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Surgery

NUCC Taxonomy Code: 208600000X

State License FL TRN27888

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Secondary Practice Locations

4301 W Markham St

Little Rock, AR 722057101

Phone: 5016867000

1600 Sw Archer Rd

Gainesville, FL 326103003

Phone: 3522738670

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1184837080

Doctor of Medicine (M.D.)

Dr. Casey Anderson , MD

Student in an Organized Health Care Education/Training Program

NPI 1558617464

Doctor of Medicine (M.D.)

Dr. Grant Bond , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1669890943

Doctor of Medicine (M.D.)

NPI 1720707037

Advanced Practice Registered Nurse, Family Nurse Practitioner (Certified), Family Nurse Practitioner (Board Certified)

Arvind Manisundaram

Surgery - Plastic and Reconstructive Surgery

NPI 1801282132

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 26, 2026

Surgery (License #E-15020 in AR)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 21, 2025

Surgery (License #T5085 in TX)

📍
Updated Practice Location February 14, 2025

Registered at 415 E SOUTHLAKE BLVD STE 101, SOUTHLAKE, TX 760926279 (Tel: 8174168080)

📍
Updated Business Mailing Address February 14, 2025

Registered at 455 NORTHWEST HWY APT 3302, IRVING, TX 750394245 (Tel: 5019203713)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 14, 2025

Plastic Surgery (License #ME169949 in FL)

📍
Updated Practice Location June 16, 2022

Registered at 1600 SW ARCHER RD, GAINESVILLE, FL 326103003 (Tel: 3522738670)

👤
Provider Name / Credentials Updated June 16, 2022

Recorded as JACOB CARLSON, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 16, 2022

Surgery (License #E-15020 in AR)

NPI Profile Active April 09, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location April 09, 2014

Registered at 4301 W MARKHAM ST, LITTLE ROCK, AR 722057101 (Tel: 5016867000)

📍
Updated Business Mailing Address April 09, 2014

Registered at 4301 W MARKHAM ST, LITTLE ROCK, AR 722057101 (Tel: 5016867000)

👤
Provider Name / Credentials Updated April 09, 2014

Recorded as JACOB CARLSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2014

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 09, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1568881282
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 09, 2014
Last Update: March 26, 2026
Sole Proprietor: No

Mailing Address

455 Northwest Hwy Apt 3302

Irving, TX 750394245

Phone: 5019203713

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.