Most Relevant Information
Provider Data
| NPI Number: | 1003041567 |
| Provider Name: | STEPHANIE JACKS |
| Entity Type: | Individual |
| Taxonomy Code: | 207N00000X |
| Specialty: | Dermatology |
| License Number: | R4401 |
Most Important Dates
| Enumeration Date: | 05/27/2009 |
| Last Updated: | 12/17/2021 |
Provider Practice Location
6701 FANNIN ST
HOUSTON
TX
770302608
Practice Location Phone/Fax
| Phone: | 8328241000 |
| Fax: |
Provider Mailing Location
2450 HOLCOMBE BLVD STE NB-34L
HOUSTON
TX
770212039
Provider Mailing Phone/Fax
| Phone: | 8328283660 |
| Fax: |