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Greg L Jackson
Parenteral & Enteral Nutrition Supplies (DME) in Addison, Texas
NPI 1063580843

Greg L Jackson is a Parenteral & Enteral Nutrition Supplies (DME) based in Addison, TX and is specialized in Parenteral & Enteral Nutrition. Greg L Jackson practices in Addison, TX. The NPI Number for Greg L Jackson is 1063580843 and holds a License No. (Texas).

The current practice location address for Greg L Jackson is 4386 Sunbelt Dr, Addison, TX and can be reached out via phone at 972-380-2065 and via fax at 972-380-9488.

Location: 4386 Sunbelt Dr, Addison, TX, 75001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1063580843
Provider Name
Greg L Jackson
Credential
Provider Entity Type
Organization
Address
4386 Sunbelt Dr, Addison, TX, 75001
Phone Number
972-380-2065
Fax Number
972-380-9488
Provider Enumeration Date
12/01/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
010118001 01 TX MEDICAID CCP
011564401 05 TX
0519596 01 TX BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
4386 Sunbelt Dr
City
Addison
State
Texas
Zip
75001
Phone Number
972-380-2065
Fax Number
972-380-9488
person
Provider Business Mailing Address Details
Address
4386 Sunbelt Dr
City
Addison
State
Texas
Zip
75001
Phone Number
972-380-2065
Fax Number
972-380-9488
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
()
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Parenteral & Enteral Nutrition
Taxonomy
332BP3500X
License No.
()
Definition
Definition to come...
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