Individual
DR. OSCAR B JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3509 LAWTON AVENUE, AUSTIN, TX 78731-6112
(512) 451-0234
(512) 451-3566
Mailing address
3509 LAWTON AVE, AUSTIN, TX 78731-6112
(512) 451-0234
(512) 451-3566
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D8288
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134810404
—
TX
01
—
891200
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/19/2006
Last updated
05/05/2008
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