Organization
JACKSON OCULOFACIAL AND COSMETIC SURGERY PA
Active
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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