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NPI Code Detail

MEDICARE: ROMESHA JACKSON

MEDICARE: ROMESHA JACKSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1376962290
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROMESHA JACKSON
Provider Business Mailing Address
First Line : 715 MARNE LN
Second Line :
City : HOUSTON
State : TX
Zip : 77090-1927
Country : US
Telephone Number : 209-242-3676
Fax Number :
Provider Business Practice Location Address
First Line : 701 N POST OAK RD STE 145
Second Line :
City : HOUSTON
State : TX
Zip : 77024-3923
Country : US
Telephone Number : 713-364-6275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2014
Last Update Date : 07/29/2024

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Directions to “ ROMESHA JACKSON ” Practice Location

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