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1073752879
RUSSELL BRENT JACKSON
SAN ANTONIO, TX
NPI
1073752879
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207X00000X Orthopaedic Surgery
(Licence: TX P5384)
Enumeration Date
2009-02-18
Last Update Date
2019-05-06
Business Address
RUSSELL BRENT JACKSON D.O.
155 E SONTERRA BLVD STE 111
SAN ANTONIO, TX 78258-3988
Phone number: 210-729-1900
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Mailing Address
RUSSELL BRENT JACKSON D.O.
PO BOX 593377
SAN ANTONIO, TX 78259-0218
Phone number: 210-494-9600
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