Individual
MS. MARILI MEDINA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5808 AIRLINE DR, AIRLINE CHILDREN'S CLINIC, HOUSTON, TX 77076-4923
(713) 695-4013
Mailing address
5808 AIRLINE DR, AIRLINE CHILDREN'S CLINIC, HOUSTON, TX 77076-4923
(713) 695-4013
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
708633
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP122290
TX
Other
Enumeration date
08/14/2012
Last updated
12/02/2019
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