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JACKSON SURGICAL CONSULTANTS P.A. NPI 1326799610


NPI Information

NPI: 1326799610
Provider Name: JACKSON SURGICAL CONSULTANTS P.A.

Doing Business As: REVIVE WELLNESS

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
1110 S FRIENDSWOOD DR
FRIENDSWOOD, TX
ZIP 77546
Phone: (409) 299-4785
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JACKSON SURGICAL CONSULTANTS P.A. is a general practice in Friendswood, TX. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee JACKSON SURGICAL CONSULTANTS P.A. NPI is 1326799610. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Revive Wellness.

The provider's business location address is:

1110 S FRIENDSWOOD DR
FRIENDSWOOD, TX
ZIP 77546-698
Phone: (409) 299-4785
Fax: (409) 220-8348

The provider's authorized official is Marissa Deluna .
The authorized official title is Credentialing Manager and has the following contact phone number (713) 800-3359.

The enumeration date for this NPI number is 1/18/2022 and was last updated on 2/3/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1171400000XHealth and Wellness CoachNo
2208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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