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General NPI Number Information
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NPI Number | 1326290578
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Entity Type | Organization
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Legal Business Name | JACKSON T. ACHILLES, MD PA
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 810 HOSPITAL DR SUITE 320
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City | BEAUMONT
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State | TX
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Zip | 77701-4600
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Country | US
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Telephone | 409-838-1116
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Fax | 409-838-0516
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Provider Business Mailing Address
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Address Line | 810 HOSPITAL DR SUITE 320
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City | BEAUMONT
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State | TX
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Zip | 77701-4600
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Country | US
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Telephone | 409-838-1116
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Fax | 409-838-0516
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. JACKSON TODD ACHILLES
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Credential | MD
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Telephone | 409-838-1116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E8280
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License Number State | TX
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