Individual
JAMES M. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12221 NORTH MOPAC EXPRESSWAY, AUSTIN, TX 78758
(512) 901-1000
Mailing address
1400 WINSTED LN, AUSTIN, TX 78703-3852
(512) 477-5645
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
H4436
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
H4436
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134602503
—
TX
05
—
134602508
—
TX
Enumeration date
06/13/2006
Last updated
05/13/2010
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