Jackson, Jerrold J
Jackson, Jerrold J is an individual health care provider with primary practice located at 1231 Greenway Dr Ste 100 , Irving TX 75038. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Jackson, Jerrold J can be contacted via phone (972) 871-1800.Contact Information
Primary practice address
1231 Greenway Dr Ste 100
Irving TX 75038
Phone: (972) 871-1800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 107746 | Texas |
Profile Details
| NPI number | 1457591455 |
|---|---|
| LBN Legal business name | Jackson, Jerrold J |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 3rd, 2009 |
| Last updated | Jul 23rd, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457591455 | NPPES |
| Michigan | Other | 46-31868 | UNITED HEALTHCARE INSURANCE |
| Michigan | MEDICAID | 40-4702665 | UNITED HEALTHCARE INSURANCE |
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