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Individual

VINEY JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6901 LOMA VISTA DR, FORT WORTH, TX 76133-6428
(682) 253-4807
(682) 224-2997
Mailing address
3701 ALTAMESA BLVD # 331652, FORT WORTH, TX 76133-5649
(682) 582-3985
(682) 224-2997

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
3747P1801X
Personal Care Attendant
Primary
20201004P
TX

Other

Enumeration date
04/28/2021
Last updated
04/28/2021
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