Individual
DR. KEVIN WADE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(915) 742-7777
Mailing address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
V1796
TX
Other
Enumeration date
04/21/2020
Last updated
04/12/2026
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