Individual
MRS. GWENDOLYN FAYE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
5743 FARWELL DR., HOUSTON, TX 77035
(832) 207-5272
(713) 485-0804
Mailing address
5743 FARWELL DR, HOUSTON, TX 77035
(832) 207-5272
(713) 485-0804
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA00411498
TX
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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