Individual
LAUREN ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2800 WILLIAM D TATE AVE STE 300, GRAPEVINE, TX 76051-4326
(972) 217-5216
Mailing address
1300 BEAR CREEK PKWY APT 1536, EULESS, TX 76039-5245
(972) 217-5216
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
TX
Other
Enumeration date
11/22/2023
Last updated
08/27/2024
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