Jackson, Lisa

Jackson, Lisa is an sole proprietor health care provider with primary practice located at 2423 Montana Blue Dr , Spring TX 77373-7871. She recently has only one registered license in Nursing Service Related Providers / Nurse's Aide, which is considered as her primary health care specialty. Jackson, Lisa can be contacted via phone (832) 484-2740.

Contact Information

Primary practice address
2423 Montana Blue Dr Spring TX 77373-7871
Phone: (832) 484-2740
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Nurse's Aide 376K00000X Texas

Profile Details

NPI number 1194292441
LBN Legal business name Jackson, Lisa
Credentials PCA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2018
Last updated Oct 25th, 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 1194292441 NPPES
Texas MEDICAID 82-4881025

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