Individual
MIRANDA C JACKSON-GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16318 ESPINOSA DR, HOUSTON, TX 77083-2812
(346) 779-9965
Mailing address
18250 ETON RIDGE CT, RICHMOND, TX 77407-2297
(346) 244-9705
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
—
—
246RP1900X
Phlebotomy Technician
Primary
CLP.204021-PHL
LA
Other
Enumeration date
05/06/2019
Last updated
02/16/2023
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