Organization
JACKSON ELITE PROFESSIONALS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUETTA JACKSON LSA (OWNER)
(214) 227-2457
Entity
Organization
Contact information
Practice address
1021 TELLURIDE DR, ARLINGTON, TX 76001-8529
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 938, ROWLETT, TX 75030-0938
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
10/03/2022
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