Jackson, Tiffany R

Jackson, Tiffany R is an individual health care provider with primary practice located at 7217 Telecom Parkway Suite 290, Garland TX 75044. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is her primary health care specialty. Jackson, Tiffany R can be contacted via phone (469) 800-2240.

Contact Information

Primary practice address
7217 Telecom Parkway Suite 290 Garland TX 75044
Fax: (469) 800-2251
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME109226 Florida
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X P5385 Texas

Profile Details

NPI number 1942491063
LBN Legal business name Jackson, Tiffany R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Jul 5th, 2023 - about last year

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 1942491063 NPPES
Texas MEDICAID 3264939-01

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