Individual
DR. PHILLIP JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4609 SCHWERIN LAKE DR, CORPUS CHRISTI, TX 78413-5255
(361) 808-9383
(361) 808-9383
Mailing address
4609 SCHWERIN LAKE DR, CORPUS CHRISTI, TX 78413-5255
(361) 808-9383
(361) 808-9383
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J4864
TX
207Q00000X
Family Medicine Physician
J4864
TX
Other
Enumeration date
01/25/2006
Last updated
08/02/2010
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