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General NPI Number Information
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NPI Number | 1306588975
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Entity Type | Individual
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Provider Name | CHRISTI RENE JACKSON MD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 7700 FISH POND RD
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City | WACO
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State | TX
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Zip | 76710-1031
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Country | US
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Telephone | 254-761-4444
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Fax | 254-761-4441
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Provider Business Mailing Address
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Address Line | PO BOX 844658
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City | DALLAS
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State | TX
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Zip | 75284-4658
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Country | US
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Telephone | 800-994-0371
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Fax | 254-215-9722
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | V1795
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License Number State | TX
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