Individual
MS. MELISSA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1350 S MAIN ST STE 1600, FORT WORTH, TX 76104-7663
(817) 702-4663
(817) 702-6924
Mailing address
1350 S MAIN ST STE 1600, FORT WORTH, TX 76104-7663
(817) 702-4663
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
67006
TX
1835I0206X
Infectious Diseases Pharmacist
67006
TX
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
67006
TX
1835P2201X
Ambulatory Care Pharmacist
67006
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2018
Last updated
05/22/2023
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