Organization
JACKSON OCULOFACIAL AND COSMETIC SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENELL JACKSON MD (MANAGING PHYSICIAN)
(404) 790-7628
Entity
Organization
Contact information
Practice address
3636 GREENBRIAR DR STE 2A, HOUSTON, TX 77098-4004
(832) 899-5699
Mailing address
1213 HERMANN DR STE 540, HOUSTON, TX 77004-7089
(404) 790-7628
Taxonomy
Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
08/11/2020
Last updated
02/16/2022
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