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Individual

MRS. JACKIE L ELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
902 W RANDOL MILL RD, SUITE 200, ARLINGTON, TX 76012-2572
(817) 461-8327
(817) 275-2525
Mailing address
16980 DALLAS PKWY, SUITE 200, DALLAS, TX 75248-1908
(817) 461-8327
(817) 275-2525

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01090
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
189128501
TX
Enumeration date
04/11/2006
Last updated
12/08/2016
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