Most Relevant Information
Provider Data
| NPI Number: | 1003537929 |
| Provider Name: | ARTHUR RAY JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 343900000X |
| Specialty: | Non-emergency Medical Transport (VAN) |
| License Number: | 11094230 |
Most Important Dates
| Enumeration Date: | 09/08/2022 |
| Last Updated: | 09/21/2022 |
Provider Practice Location
97 BIRDIE CIR
LA PORTE
TX
775717277
Practice Location Phone/Fax
| Phone: | 2818893366 |
| Fax: |
Provider Mailing Location
97 BIRDIE CIR
LA PORTE
TX
775717277
Provider Mailing Phone/Fax
| Phone: | 2818893366 |
| Fax: |