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Individual

LINDA SUE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
17051 DALLAS PKWY, SUITE 400, ADDISON, TX 75001-7109
(214) 370-3535
(214) 370-0004
Mailing address
17051 DALLAS PKWY, SUITE 400, ADDISON, TX 75001-7109
(214) 370-3535
(214) 370-0004

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
02046
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
209277701
TX
01
8Y9248
BCBSTX
TX
Enumeration date
08/04/2006
Last updated
06/15/2022
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