Jackson, Richard

Jackson, Richard is an individual health care provider with primary practice located at 505 Regency Xing , Southlake TX 76092-9501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Jackson, Richard can be contacted via phone (817) 913-6144.

Contact Information

Primary practice address
505 Regency Xing Southlake TX 76092-9501
Phone: (817) 913-6144
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X K8228 Texas

Profile Details

NPI number 1659328060
LBN Legal business name Jackson, Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Jan 17th, 2008 - about 18 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 1659328060 NPPES
Texas Other 8G7458 BCBS THRU HEB
Texas Other P00374822 BCBS THRU HEB

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