MEDICARE: MR. CHARLES WAYNE JACKSON LPC

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	101YP2500X	Professional Counselor	63795	TX

General Provider Information

NPI Number	:	1871742791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES WAYNE JACKSON LPC

Provider Business Mailing Address
First Line	:	16320 HUEBNER RD STE 200
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78248-1690
Country	:	US
Telephone Number	:	210-425-5047
Fax Number	:	830-215-0223

Provider Business Practice Location Address
First Line	:	16320 HUEBNER RD STE 200
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78248-1690
Country	:	US
Telephone Number	:	210-425-5047
Fax Number	:	830-215-0223

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

Provider Enumeration Date	:	09/16/2008
Last Update Date	:	09/19/2021

Similar Medicare Providers

1619645975 — THE EXTENDED OLIVE BRANCH COUNSELING CENTER LLC
Practice Location Address:

16320 HUEBNER RD STE 200
SAN ANTONIO, TX
78248-1690

Practice Phone: 830-443-0553
Practice Fax: 830-215-0223

1346217643 — ALEJANDRO GARCIA II MD
Practice Location Address:

4315 MOONLIGHT WAY , SUITE 102
SAN ANTONIO, TX
78230-1690

Practice Phone: 210-558-1558
Practice Fax: 210-558-1814

1801903885 — CARMEN CAWLEY MD
Practice Location Address:

4315 MOONLIGHT WAY STE 102
SAN ANTONIO, TX
78230-1690

Practice Phone: 210-510-2141
Practice Fax: 210-510-2135

1205966819 — COURTNEY SPRAGUE ALDRIDGE PA-C
Practice Location Address:

9238 FLOYD CURL DR , STE 101
SAN ANTONIO, TX
78240-1690

Practice Phone: 210-558-6234
Practice Fax: 210-615-1840

1174712228 — RYAN O'QUINN MD
Practice Location Address:

9238 FLOYD CURL DR , SUITE 101
SAN ANTONIO, TX
78240-1690

Practice Phone: 210-558-6234
Practice Fax: 210-615-1840

1306162920 — SOUTH TEXAS AMBULATORY SURGERY CENTER, PLLC
Practice Location Address:

9238 FLOYD CURL DR
SAN ANTONIO, TX
78240-1690

Practice Phone: 210-558-6234
Practice Fax: 210-615-1840

Directions to “ MR. CHARLES WAYNE JACKSON LPC” 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.