ANTONIOUS DEWAYNE JACKSON

BEDFORD, TX
NPI1205037322
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: TX  AP133741)
Additional Taxonomies111NR0400X Chiropractor, Rehabilitation
(Licence: TX  DC9074)
Enumeration Date2007-05-29
Last Update Date2017-04-12
Business Address
-- ANTONIOUS DEWAYNE JACKSON D.C., F.N.P-C
2900 HIGHWAY 121 STE 120
BEDFORD, TX 76021-4033
Phone number: 817-921-3000
Mailing Address
-- ANTONIOUS DEWAYNE JACKSON D.C., F.N.P-C
PO BOX 627
HURST, TX 76053-0627
Phone number: 817-770-3565
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