Richard J Jackson
Pediatric Surgery
1901 Sw H K Dodgen Loop
Temple
, Texas 76502-3500
Richard J Jackson
Pediatric Surgery
1901 Sw H K Dodgen Loop
Temple
, Texas 76502-3500
(254) 724-2111
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Richard J Jackson
- Po Box 844658
- Dallas, TX
- Zip : 75284-4658
- Phone : (254) 724-2111
Second Address
- Richard J Jackson
- 1901 Sw H K Dodgen Loop
- Temple, TX
- Zip : 76502-3500
- Fax : (254) 935-4111
- Phone : (254) 935-4000
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 2086S0120X | Pediatric Surgery | N-8271 | AR |
| Y | 2086S0120X | Pediatric Surgery | N3094 | TX |
National Provider Identifier
| NPI | 1215027883 |
|---|---|
| Provider Name | Richard J Jackson |
| First Address | Dallas, TX 75284-4658 |
| Second Address | Temple, TX 76502-3500 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/10/2006 |
| Last Update Date | 08/06/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 121627001 | (05) | AR |
| 125912907 | (05) | TX |
| 125912908 | (05) | TX |
| 137345810 | (05) | TX |
| 140442852 | (05) | TX |
| F14239 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.