Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | BP10047525 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | R1048 | TX |
NPI | 1235576471 |
---|---|
Provider Name | Dr. Lindsey Ann Jackson |
First Address | Boerne, TX 78006-3312 |
Second Address | Boerne, TX 78006-3312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2013 |
Last Update Date | 20/08/2020 |