Jackson, Lance Elliot

Jackson, Lance Elliot is an individual health care provider with primary practice located at 18518 Hardy Oak Suite 300, San Antonio TX 78258-4271. He recently has 4 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otology & Neurotology, Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Otolaryngic Allergy. Allopathic & Osteopathic Physicians / Otology & Neurotology is his primary health care specialty. Jackson, Lance Elliot can be contacted via phone (210) 696-4327.

Contact Information

Primary practice address
18518 Hardy Oak Suite 300 San Antonio TX 78258-4271
Phone: (210) 696-4327
Fax: (210) 798-2509
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X L5777 Texas
Allopathic & Osteopathic Physicians / Otology & Neurotology 207YX0901X L5777 Texas
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X L5777 Texas
Allopathic & Osteopathic Physicians / Otolaryngic Allergy 207YX0602X L5777 Texas

Profile Details

NPI number 1174554521
LBN Legal business name Jackson, Lance Elliot
Credentials M.D., F.A.C.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Jan 25th, 2013 - about 12 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 1174554521 NPPES
Texas Other P00019999 RAILROAD MEDICARE
Texas MEDICAID 157518501 RAILROAD MEDICARE
Texas Other 7047136 RAILROAD MEDICARE
Texas Other 8H5000 RAILROAD MEDICARE
Texas Other MDL5777 RAILROAD MEDICARE

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