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General NPI Number Information
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NPI Number | 1275715468
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Entity Type | Organization
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Legal Business Name | PRECISE MID-LEVEL PROVIDER SERVICES OF HOUSTON, PLLC
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 5811 CYPRESSWICK CIR
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City | SPRING
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State | TX
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Zip | 77379-7996
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Country | US
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Telephone | 832-878-5352
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Fax | 281-257-0422
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Provider Business Mailing Address
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Address Line | 5811 CYPRESSWICK CIR
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City | SPRING
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State | TX
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Zip | 77379-7996
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Country | US
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Telephone | 832-878-5352
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Fax | 281-257-0422
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Authorized Official
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Title or Position | CEO
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Name | MS. TONIA LYNETTE JACKSON
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Credential | FNP-C
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Telephone | 832-878-5352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 624607
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License Number State | TX
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