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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457591455 NPPES
Michigan Other 46-31868 UNITED HEALTHCARE INSURANCE
Michigan MEDICAID 40-4702665 UNITED HEALTHCARE INSURANCE

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