MEDICARE: JAZZMIN 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
1	2355S0801X	Speech-Language Assistant	37181	TX

General Provider Information

NPI Number	:	1922422872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZZMIN JACKSON

Provider Business Mailing Address
First Line	:	780 SAWDUST RD APT 160
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-4149
Country	:	US
Telephone Number	:	281-687-2854
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 SAWDUST RD APT 160
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-4149
Country	:	US
Telephone Number	:	281-687-2854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2014
Last Update Date	:	04/21/2026

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Directions to “ JAZZMIN JACKSON ” Practice Location

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