Jackson, Shaun Chadrick

Jackson, Shaun Chadrick is an individual health care provider with primary practice located at 423 Treeline Park Suite 325, San Antonio TX 78209-2060. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Jackson, Shaun Chadrick can be contacted via phone (210) 805-9800.

Contact Information

Primary practice address
423 Treeline Park Suite 325 San Antonio TX 78209-2060
Phone: (210) 805-9800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X M9372 Texas
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X M9372 Texas
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X M9372 Texas

Profile Details

NPI number 1407013691
LBN Legal business name Jackson, Shaun Chadrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2008
Last updated Jun 3rd, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407013691 NPPES
Texas Other M9372 MEDICAL LICENSE
Texas Other 8L0027 MEDICAL LICENSE
Texas MEDICAID 1984007-01 MEDICAL LICENSE

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