Individual
DORIS ANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19321 PARK ROW APT 1211, HOUSTON, TX 77084-4892
(423) 645-9932
Mailing address
19321 PARK ROW APT 1211, HOUSTON, TX 77084-4892
(423) 645-9932
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
341645
TX
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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