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General NPI Number Information
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NPI Number | 1699149278
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Entity Type | Individual
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Provider Name | JOYCE JACKSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 1515 N ALEXANDER DR
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City | BAYTOWN
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State | TX
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Zip | 77520-5321
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Country | US
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Telephone | 281-427-3252
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Fax |
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Provider Business Mailing Address
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Address Line | 11102 LLAMA LN
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City | STAFFORD
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State | TX
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Zip | 77477-1257
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Country | US
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Telephone | 281-865-7279
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 50853
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License Number State | TX
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