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Individual

HOLLY JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4421 HIGHWAY 6 S STE 100, COLLEGE STATION, TX 77845-6176
(979) 731-5200
(979) 731-5210
Mailing address
805 HILL BLVD UNIT 104, GRANBURY, TX 76048-1482
(817) 573-5760

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10119
TX

Other

Enumeration date
11/17/2015
Last updated
01/23/2023
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