Jackson, Antonious Dewayne

Jackson, Antonious Dewayne is an sole proprietor health care provider with primary practice located at 2900 Highway 121 Ste 120 , Bedford TX 76021-4033. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Rehabilitation, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Jackson, Antonious Dewayne can be contacted via phone (817) 921-3000.

Contact Information

Primary practice address
2900 Highway 121 Ste 120 Bedford TX 76021-4033
Phone: (817) 921-3000
Fax: (817) 921-3001
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Rehabilitation 111NR0400X DC9074 Texas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP133741 Texas

Profile Details

NPI number 1205037322
LBN Legal business name Jackson, Antonious Dewayne
Credentials D.C., F.N.P-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 29th, 2007
Last updated Apr 12th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers