Organization
O. B. JACKSON, JR.,MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR B JACKSON JR. M.D. (PRESIDENT)
(512) 451-0234
Entity
Organization
Contact information
Practice address
3509 LAWTON AVE, AUSTIN, TX 78731-6112
(512) 451-0234
(512) 451-3566
Mailing address
3509 LAWTON AVE, AUSTIN, TX 78731-6112
(512) 451-0234
(512) 451-3566
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D8288
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134810405
—
TX
Enumeration date
04/02/2008
Last updated
05/05/2008
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