Individual
RUSSELL BRENT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
155 E SONTERRA BLVD STE 111, SAN ANTONIO, TX 78258-3988
(210) 729-1900
(210) 729-1901
Mailing address
PO BOX 593377, SAN ANTONIO, TX 78259-0218
(210) 494-9600
(210) 494-9601
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
P5384
TX
Other
Enumeration date
02/18/2009
Last updated
05/06/2019
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