Individual
DR. ROBERT WAYNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17070 RED OAK DR., SUITE 409, HOUSTON, TX 77090-2617
(281) 440-8090
(281) 440-9959
Mailing address
17070 RED OAK DR., SUITE 409, HOUSTON, TX 77090-2617
(281) 440-8090
(281) 440-9959
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
E4426
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0352122-01
—
TX
Enumeration date
04/24/2006
Last updated
02/23/2012
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