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:
Health care specialties
Specialty | Code | License # | 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 5 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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