MEDICARE: KATRINA JACKSON IRVING PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA11078	TX
2	363A00000X	Physician Assistant	PA11078	TX

General Provider Information

NPI Number	:	1427594381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA JACKSON IRVING PA

Provider Business Mailing Address
First Line	:	1400 HOSPITAL PKWY STE 100
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76022-6928
Country	:	US
Telephone Number	:	817-684-2700
Fax Number	:	817-684-2709

Provider Business Practice Location Address
First Line	:	1000 FLOWER MOUND RD
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-3401
Country	:	US
Telephone Number	:	972-434-1988
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2017
Last Update Date	:	05/20/2026

Similar Medicare Providers

1003818170 — JACQUELYN ANN STANFIELD D.D.S.
Practice Location Address:

3401 CROSS TIMBERS RD , STE 100
FLOWER MOUND, TX
75028-2900

Practice Phone: 972-355-2273
Practice Fax: 972-539-8568

1346298304 — SHIRLEY A. WILLIAMS M.D.
Practice Location Address:

1000 FLOWER MOUND RD
FLOWER MOUND, TX
75028-3401

Practice Phone: 972-434-1988
Practice Fax:

1427083203 — MARY GEORGE HANNA YOUSSEF MD
Practice Location Address:

1000 FLOWER MOUND RD
FLOWER MOUND, TX
75028-3401

Practice Phone: 972-434-1988
Practice Fax:

1013556232 — FLOWER MOUND TEXAS DENTAL
Practice Location Address:

3401 CROSS TIMBERS RD STE 100
FLOWER MOUND, TX
75028-2900

Practice Phone: 972-355-2273
Practice Fax:

1982161923 — ELIZABETH R WHEELER MSW
Practice Location Address:

9408 FLOWER AVE
SILVER SPRING, MD
20901-3401

Practice Phone: 301-792-4118
Practice Fax:

1134525801 — BRENDON WHITNEY LLPC
Practice Location Address:

38271 MOUND RD
STERLING HEIGHTS, MI
48310-3401

Practice Phone: 586-477-2054
Practice Fax:

Directions to “ KATRINA JACKSON IRVING PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.