Individual
JACKSON EDWARD MASSANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2017 BROADWAY ST, PEARLAND, TX 77581-5501
(281) 485-9990
(281) 485-9469
Mailing address
1 BAYLOR PLZ # BCM320, HOUSTON, TX 77030-3411
(832) 824-1170
(832) 825-6497
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
U9595
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2021
Last updated
07/18/2025
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