Individual
LINDA JOHNSON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 645-2020
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
04275TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093283203
—
TX
Enumeration date
03/18/2006
Last updated
02/18/2020
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