Individual
SHAWNDREA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9530 FLYING EAGLE CT, HOUSTON, TX 77083-5183
(713) 679-3592
Mailing address
9530 FLYING EAGLE CT, HOUSTON, TX 77083-5183
(713) 679-3592
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/28/2014
Last updated
03/10/2014
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