Organization
JACKSON NEUROSCIENCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY VINING PMHNP (CLINIC MANAGER)
(601) 214-9385
Entity
Organization
Contact information
Practice address
6514 HIGHWAY 90A STE 101, SUGAR LAND, TX 77498-2120
(281) 915-2370
(281) 915-2374
Mailing address
PO BOX 2936, SUGAR LAND, TX 77487-2936
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/11/2022
Last updated
08/25/2022
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