Individual
MELISA ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 S BENDER AVE APT 513, HUMBLE, TX 77338-7717
(281) 608-1710
Mailing address
401 S BENDER AVE APT 513, HUMBLE, TX 77338-7717
(281) 608-1710
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-3877014
NON-EMERGENCY MEDICAL TRANSPORTATION
TX
Enumeration date
01/02/2020
Last updated
01/02/2020
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