Individual
LENITA C JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
18511 EGRET BAY BLVD, APT 105, HOUSTON, TX 77058-3838
(409) 354-9701
(281) 333-3686
Mailing address
PO BOX 590896, HOUSTON, TX 77259-0896
(409) 354-9701
(281) 333-3686
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
789762
TX
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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