Individual
PAUL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2229 PUEBLO DR, GARLAND, TX 75040-4328
(214) 734-8394
(972) 414-1261
Mailing address
2229 PUEBLO DR, GARLAND, TX 75040-4328
(214) 734-8394
(972) 414-1261
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/10/2012
Last updated
04/10/2012
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