Individual
DR. GREGORY MANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4220 MCCULLOUGH AVE, SAN ANTONIO, TX 78212-1910
(210) 829-0700
(210) 829-0714
Mailing address
4220 MCCULLOUGH AVE, SAN ANTONIO, TX 78212-1910
(210) 829-0700
(210) 829-0714
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F5584
TX
Other
Enumeration date
08/19/2006
Last updated
11/19/2010
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