Individual
MRS. LILLIE R. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 KENRICK DR STE C26, HOUSTON, TX 77060-3698
(832) 265-5753
(281) 448-0768
Mailing address
PO BOX 112087, HOUSTON, TX 77293-2087
(832) 265-5753
(281) 448-0768
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
—
—
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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