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General NPI Number Information
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NPI Number | 1992286090
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Entity Type | Individual
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Provider Name | JACKSON HUMPHREY DC
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Gender | Male
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 400 W HIGHWAY 290 STE B203
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-4382
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Country | US
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Telephone | 512-829-5216
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Fax | 512-379-6081
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Provider Business Mailing Address
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Address Line | 400 W HIGHWAY 290 STE B203
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-4382
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Country | US
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Telephone | 512-829-5216
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Fax | 512-379-6081
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13772
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License Number State | TX
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