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General NPI Number Information
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NPI Number | 1033413091
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Entity Type | Organization
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Legal Business Name | TANIA WHITE-JACKSON, PA
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 6300 W PARKER RD BLDG 2 STE 325
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City | PLANO
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State | TX
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Zip | 75093-8100
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Country | US
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Telephone | 972-981-3535
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Fax | 972-981-3536
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Provider Business Mailing Address
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Address Line | 6300 W PARKER RD BLDG 2 STE 325
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City | PLANO
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State | TX
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Zip | 75093-8100
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Country | US
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Telephone | 972-981-3535
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Fax | 972-981-3536
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Authorized Official
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Title or Position | PHYSICAIN
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Name | TANIA W JACKSON
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Credential | M.D
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Telephone | 972-981-3535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | J9439
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License Number State | TX
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