Most Relevant Information
Provider Data
| NPI Number: | 1003396185 |
| Provider Name: | PATRICIA JACKSON LVN |
| Entity Type: | Individual |
| Taxonomy Code: | 164X00000X |
| Specialty: | Licensed Vocational Nurse |
| License Number: | 101430 |
Most Important Dates
| Enumeration Date: | 08/17/2018 |
| Last Updated: | 08/17/2018 |
Provider Practice Location
24310 FOREST CANOPY DR
KATY
TX
774933088
Practice Location Phone/Fax
| Phone: | 7135947923 |
| Fax: |
Provider Mailing Location
24310 FOREST CANOPY DR
KATY
TX
774933088
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |