Healthcare Provider Details

I. General information

NPI: 1891840567
Provider Name (Legal Business Name): RONDA L JACKSON RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 BELT LINE RD SUITE 135
GARLAND TX
75040-3665
US

IV. Provider business mailing address

7706 CREEK WOOD DR
ROWLETT TX
75089-2491
US

V. Phone/Fax

Practice location:
  • Phone: 972-530-9933
  • Fax: 972-530-9004
Mailing address:
  • Phone: 214-505-1062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number639368
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License Number010309
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: