Jackson, Terri D.

Jackson, Terri D. is an individual health care provider with primary practice located at 3310 Live Oak St Youth & Family Center, Dallas TX 75204-6153. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jackson, Terri D. can be contacted via phone (214) 266-1257.

Contact Information

Primary practice address
3310 Live Oak St Youth & Family Center Dallas TX 75204-6153
Phone: (214) 266-1257
Fax: (214) 266-1258
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00941 Texas

Profile Details

NPI number 1750381752
LBN Legal business name Jackson, Terri D.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2005
Last updated Sep 3rd, 2009 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1750381752 NPPES
Texas MEDICAID 179959501
Texas MEDICAID 179959502
Texas Other 8N4447
Texas Other P00051267

Popular Providers