Individual
DR. DANETTE M. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
BLDG 2245, 761ST TANK DESTROYER BLVD, CHARLES THOMAS MOORE CLINIC, FT CAVAZOS, TX 76544
(254) 285-6232
Mailing address
590 MEDICAL CENTER ROAD, FT. CAVAZOS, TX 76544
(254) 288-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO-02419
IA
Other
Enumeration date
09/06/2006
Last updated
08/14/2023
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