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1124568548
JACKSON PRESTWOOD
JBSA FT SAM HOUSTON, TX
NPI
1124568548
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208D00000X General Practice
(Licence: VA 0101265195)
Enumeration Date
2017-03-04
Last Update Date
2023-06-07
Business Address
JACKSON PRESTWOOD MD
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 78234-4504
Phone number: 210-916-8666
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Mailing Address
JACKSON PRESTWOOD MD
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 78234-4504
Phone number: 210-916-8666
Copy
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