MEDICARE: SHERICKA JACKSON

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	208000000X	Pediatrics Physician	1153190	TX

General Provider Information

NPI Number	:	1851263149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERICKA JACKSON

Provider Business Mailing Address
First Line	:	1411 N BECKLEY AVE STE 366
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-1592
Country	:	US
Telephone Number	:	214-941-2777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 N BECKLEY AVE STE 366
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-1592
Country	:	US
Telephone Number	:	214-941-2777
Fax Number	:

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

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	09/18/2025

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Directions to “ SHERICKA JACKSON ” Practice Location

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