Individual
TIFFANI THERESSA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6701 FANNIN ST, HOUSTON, TX 77030
(832) 824-1000
Mailing address
2 GREENWAY PLZ STE 300, HOUSTON, TX 77046-0207
(832) 828-3660
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
AP130134
TX
363LN0000X
Neonatal Nurse Practitioner
Primary
AP130134
TX
Other
Enumeration date
02/02/2016
Last updated
06/11/2018
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