Individual
MARLISCHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21970 BULVERDE RD STE 103, SAN ANTONIO, TX 78259-2179
(210) 625-5708
(888) 227-1442
Mailing address
21970 BULVERDE RD STE 103, SAN ANTONIO, TX 78259-2179
(210) 625-5708
(888) 227-1442
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP136994
TX
363LF0000X
Family Nurse Practitioner
AP136994
TX
363LP0200X
Pediatric Nurse Practitioner
AP136994
TX
Other
Enumeration date
03/14/2018
Last updated
03/04/2026
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