Organization
JACKSON SURGICAL CONSULTANTS P.A.
Active
Other names
Revive Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA DELUNA (CREDENTIALING MANAGER)
(713) 800-3359
Entity
Organization
Contact information
Practice address
1110 S FRIENDSWOOD DR, FRIENDSWOOD, TX 77546-5698
(409) 299-4785
(409) 220-8348
Mailing address
12337 JONES RD STE 427, HOUSTON, TX 77070-4951
(409) 299-4785
(409) 220-8348
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/18/2022
Last updated
02/03/2022
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